432A.780 Revocation of license for violation
of statute or regulation.

REVISER’S NOTE.

Chapter 261, Statutes of Nevada 2011, abolished the
Board for Child Care and transferred its duties to the State Board of Health.
This bill also: (1) abolished the Bureau of Services for Child Care and
transferred its duties to the Health Division (now the Division of Public and
Behavioral Health) of the Department of Health and Human Resources; and (2)
transferred the duties of the Chief of the Bureau to the Administrator of the
Health Division.

GENERAL PROVISIONS

NAC 432A.010Definitions. (NRS 432A.077)As used
in this chapter, unless the context otherwise requires, the words and terms
defined in NAC 432A.012 to 432A.165,
inclusive, have the meanings ascribed to them in those sections.

NAC 432A.040“Child” defined. (NRS
432A.077)“Child”
means a person who has not reached his or her 18th birthday.

[Bd. for Child Care, Child Care Facilities Reg. § 1.7,
eff. 2-28-80]

NAC 432A.050“Child care center” defined. (NRS
432A.077)“Child
care center” means any facility in which the licensee regularly provides day or
night care for more than 12 children and which is developmentally appropriate
for those children.

NAC 432A.075“Child with special needs” defined. (NRS
432A.077)“Child
with special needs” means a child who does not function according to
expectations appropriate to his or her age and who regularly requires special
assistance or accommodations.

NAC 432A.079“Developmentally appropriate care and education” defined. (NRS 432A.077)“Developmentally
appropriate care and education” means the provision of care or education in a
manner that takes into account:

1. The universal, predictable sequences of
child development;

2. The particular sequences of child
development of each child cared for in a facility; and

3. The principle that children learn best
when learning is meaningful to them and is based on “first-hand” experiences.

(Added to NAC by Bd. for Child Care by R112-06, eff. 4-23-2009)

NAC 432A.080“Director” defined. (NRS
432A.077)“Director”
means the licensee or a person appointed by the licensee who is responsible for
the daily operation, administration and management of the facility.

(Added to NAC by Bd. for Child Care, eff. 6-5-84; A 11-19-85;
11-1-94)—(Substituted in revision for NAC 432A.115)

NAC 432A.083“Early care and education program” defined. (NRS 432A.077)“Early
care and education program” means a program in which developmentally
appropriate care and education are provided to children based on the ages of
the children served and on the type of setting within which that care and
education are provided.

1. Provides temporary care to children for
an amount of time that is more than 3 1/2 hours but is within the limits of
time set forth in subsection 4 of NAC 432A.436;
and

2. Provides such care while the person
responsible for placing the child in the extended care accommodation facility
remains on the premises of the business establishment which operates the
extended care accommodation facility.

(a) Operated by a business that is licensed to
conduct a business other than the provision of care to children; and

(b) Located on the premises of a business at which
a special event is held.

2. The term does not include care to
children that is provided in a hotel or motel room or in the private home of a
person who is attending a special event.

(Added to NAC by Bd. for Child Care by R112-06, eff. 4-23-2009)

NAC 432A.100“Family home” defined. (NRS
432A.077)“Family
home” means any facility in which the licensee regularly provides care without
the presence of parents, for at least five and not more than six children.

NAC 432A.140“Licensee” defined. (NRS
432A.077)“Licensee”
means the person or public organization licensed pursuant to this chapter and
who is responsible for the operation of a facility and adherence to the
provisions of this chapter.

[Bd. for Child Care, Child Care Facilities Reg. § 1.17,
eff. 2-28-80]

NAC 432A.143“Nevada Registry” defined. (NRS 432A.077)“Nevada
Registry” means the organization that operates the statewide system of career
development and recognition created to:

1. Acknowledge and encourage professional
achievement in the early childhood care and education workforce in this State;

2. Establish a professional development
system in this State for the field of early childhood care and education;

3. Approve and track all informal training
in the field of early childhood care and education in this State; and

4. Act as a statewide clearinghouse of
information concerning the field of early childhood care and education.

1. “Shelter child care institution” means a
child care institution which provides residential care on a 24-hour basis to
children who are in the custody of an agency which provides child welfare
services and who are in need of temporary protection and care.

2. As used in this section, “agency which
provides child welfare services” has the meaning ascribed to it in NRS 432B.030.

(Added to NAC by Bd. for Child Care by R112-06, eff. 4-23-2009)

NAC 432A.165“Special needs facility” defined. (NRS
432A.077)“Special
needs facility” means a child care facility providing care to children with
special needs in which those children comprise 40 percent or more of the total
number of children for whom the facility is licensed to provide care.

NAC 432A.180Regulation of local licensing agencies by Division. (NRS 432A.077)

1. Any county or city which desires to
establish or has established a child care licensing agency must file a copy of
any proposed ordinance or regulation for licensing facilities with the Division
for review not later than 30 days before a public hearing is held on the
proposed ordinance or regulation. The ordinance or regulation adopted by the
county or city must be filed with the Division for its approval within 30 days
after adoption.

2. Every local licensing agency shall submit
on a quarterly basis to the Division a roster of all facilities in its
jurisdiction which are currently licensed.

1. Inspections of any building or premises
of a facility pursuant to NRS
432A.180 may be unannounced and must be made at least two times during the
12-month licensing period or once every 6 months. Any authorized member or
employee of the Division may enter and inspect any building or premises of a
facility at any time pursuant to NRS
432A.180 to secure compliance with or prevent a violation of any provision
of this chapter or chapter 432A of
NRS.

2. In conducting inspections and
investigations, the Division may call upon political subdivisions and
governmental agencies for assistance. The licensee or applicant shall cooperate
with the person conducting the investigation by providing access to the
buildings, records and staff of the facility. Failure to provide such access is
a ground for revocation of a license or denial of an application for a license.

3. On confirmation of the operation of an
unlicensed operator of a facility, the Division or the local licensing agency
shall investigate and attempt to license the operator of the facility, force
discontinuance of the operation of the facility or prosecute the violation.

1. An application for an initial license to
operate a facility must be:

(a) Submitted to the Division on a form supplied by
the Division; and

(b) Accompanied by the following appropriate fee:

(1) If the
facility is to provide care for 5 or 6 children........................................

$20

(2) If the
facility is to provide care for 7 or more but not more than 12 children

60

(3) If the
facility is to provide care for 13 or more but not more than 50 children..........................................................................................................................

100

(4) If the
facility is to provide care for 51 or more but not more than 100 children..........................................................................................................................

150

(5) If the
facility is to provide care for 101 or more but not more than 150 children..........................................................................................................................

200

(6) If the
facility is to provide care for 151 or more but not more than 200 children..........................................................................................................................

250

(7) If the
facility is to provide care for more than 200 children..........................

300

2. After receiving a completed application
and payment of the appropriate fee, the Division shall:

(a) Conduct an investigation into the
qualifications and background of:

(1) Every applicant and his or her employees,
other than an educational intern who provides direct care to children for a
period of less than 6 months; and

(2) Every resident of the facility who is 18
years of age or older;

(b) Conduct a partial investigation into the
qualifications and background of every resident of the facility who is at least
16 years of age but less than 18 years of age;

(c) Conduct a partial investigation into the
background of every volunteer of the facility who is at least 16 years of age
and who regularly works for 15 hours or more per week in the facility;

(d) Inspect the buildings of the facility; and

(e) Examine the plans for care of the children and
management of the facility.

3. Documentation of completed and current
investigations must be kept on file at the facility for all persons required to
be investigated, for the period of their presence at the facility.

4. Fingerprints must be taken and
applications for investigations must be made by:

(a) Every employee or a resident of the facility
who is at least 18 years of age and every volunteer who is at least 18 years of
age and who regularly works for 15 hours or more per week in the facility
within 3 working days after the date of hiring or his or her presence in the
facility, and every 6 years thereafter.

(b) An applicant at the time of an application for
initial license.

(c) A licensee every 6 years after the date his or
her license is originally issued.

5. Every 2 years after the investigation
conducted pursuant to subsection 2 is completed, the Division shall conduct a
partial investigation into the background of each volunteer who is at least 16
years of age and who regularly works for 15 hours or more in a facility and
into the background of each licensee and employee of a facility.

6. The Division shall immediately notify the
applicant or licensee if the investigation conducted pursuant to subsection 2
or 5 indicates that he or she or an employee or resident of the facility or a
volunteer who regularly works for 15 hours or more per week in the facility has
been convicted of any offense listed in subsection 2 of NRS 432A.170.

7. The license must not be issued until the
Administrator of the Division is satisfied that the proposed facility will be
in compliance with the applicable codes concerning safety of human life,
environmental health, and building and zoning, as established respectively by
the State Fire Marshal, the State Board of Health and the appropriate local
government. A report of inspection by the State Fire Marshal or the Bureau of
Health Protection Services of the Division, finding satisfactory conditions,
may be accepted by the Administrator as proof of compliance with the applicable
regulations.

8. With the exception of a facility that is
licensed by a branch of the military or naval service of the United States, a
licensee who has a license to operate a family home or a group home may not
obtain a license to operate any other family home, group home or other child
care facility.

9. An applicant must, before a license is
issued to him or her, submit to the Division a certificate stating that he or
she holds a policy of insurance for protection against liability to third
persons which will meet the requirement set forth in subsection 2 of NAC 432A.290. Any government, governmental agency or
political subdivision of a government which operates a child care facility and
is self-insured is not required to furnish a certificate of insurance to the
Division.

10. If the applicant and the proposed
facility are in compliance with the provisions of this chapter, as shown by his
or her application and related material and the investigation, a license will
be issued to the applicant within 30 days after completion of the
investigation.

11. A licensee shall return to the Division
his or her license if he or she ceases to operate a facility, if the license
has been suspended or revoked or if the license is placed on a provisional
basis.

12. As used in this section, “partial
investigation” includes, at a minimum, checking the Statewide Central Registry
for the Collection of Information Concerning the Abuse or Neglect of a Child
established by NRS 432.100 and
performing a background check with local law enforcement.

The regulation of the Board for Child Care filed with
the Secretary of State on July 1, 2004 (LCB File No. R203-03), which amended
this section, contains the following provisions not included in NAC:

“Notwithstanding the amendatory provisions of
subsection 7 [now subsection 8] of NAC 432A.200, a
licensee of a family home or a licensee of a group home who has more than one
license to operate a child care facility on July 1, 2004, may:

1. Apply, pursuant to NAC 432A.220, for the reissuance of each of those
licenses held on July 1, 2004; and

2. Continue to operate each child care
facility for which he has a license until his license to operate that child
care facility is suspended, revoked or otherwise terminated.”

1. Each license must contain the name of
each person authorized to operate the facility, the location of the facility,
the number of children for whom care may be provided pursuant to the license
and the nature of child care services which may be provided.

2. The current license issued to an operator
of a facility must be signed by the Administrator of the Division and
conspicuously posted in a public place within the facility.

3. The license is not transferable from one
licensee to another licensee or from a licensee to a person who is not a
licensee. A license is valid only for the premises described in the license.

4. Except as otherwise provided in this
chapter, a licensee may not care for a greater number of children than the
number set forth on the license issued to the licensee.

1. Except as otherwise provided in NAC 432A.437, a licensee of a facility may apply for
reissuance of a license by submitting an application for reissuance which must
be received by the Division, or postmarked if mailed, not later than 45 days
before the expiration of the license. The Division shall provide all forms and
materials necessary for reissuance of a license. The Division shall charge a
late fee of $50 for an application for reissuance of a license that is received
or postmarked later than 30 days before the expiration of the license.

2. After receipt of an application for
reissuance of a license and the receipt of a fee for reissuance computed in the
same manner described in subsection 1 of NAC 432A.200,
the Division shall conduct a survey to determine whether the licensee of a
facility meets all of the requirements for issuance of a license set forth in NAC 432A.200.

3. If, after investigation, the Division
determines that the facility complies with the requirements of NAC 432A.200, a license must be reissued for 1 year.
A reissued license may be revoked or suspended on the same grounds as an
initial license.

1. A licensee may request that his or her
license be transferred to inactive status by the Division. If the request is
approved, the licensee shall, within 15 days after the approval, give written
notification to the parents of any children in the facility that the license is
inactive.

2. Inactive status does not continue beyond
the expiration of the license.

1. In addition to the grounds set forth in NRS 432A.190, the Division may
suspend or revoke the license of a licensee on the ground that:

(a) The health or safety of a child in the facility
is being endangered; or

(b) The facility is not in compliance with
standards for safety from fire and other emergencies or standards for health and
sanitation as determined by the Division after an inspection of any building or
premises of the facility conducted pursuant to NRS 432A.180.

2. The notice of denial, suspension or revocation
required by NRS 432A.200 must
be sent by the Division within 30 days after its determination to suspend or
revoke a license or to deny an application for a license.

NAC 432A.233Group homes for which license as nursery for infants and toddlers
not required. (NRS 432A.077)A group
home is not required to be licensed as a nursery for infants and toddlers if
the licensee does not provide care for more than eight children who are under 3
years of age.

1. A person who desires a waiver of all or
any part of the Board’s regulations concerning licensing must submit a
completed application for the waiver to the Division or other appropriate
agency for the licensing of facilities.

2. An application for a waiver filed with
the Board must be submitted to the Board at its next regularly scheduled
meeting if the waiver is filed 60 days before that meeting. The application
must be accompanied by the recommendation of the Division and the appropriate
agency for the licensing of facilities.

3. The Board will grant a waiver if it
determines that good cause exists. The Board will not grant a waiver which will
threaten public health or safety.

4. The Board will specify the length of time
a waiver is in effect.

5. A waiver granted by the Board will be
revoked before the expiration of the period of the waiver if, after a public
hearing, the Board determines that the public health or safety is threatened or
the basis upon which the waiver was granted no longer exists.

6. For the purposes of this section, “good
cause” exists when an applicant is unduly burdened by a regulation of the Board
and thereby suffers a severe hardship because of circumstances or conditions
which are unique to the applicant.

1. A building used as a facility must, upon
a change of operating ownership, comply with the provisions of this chapter and
applicable building and safety codes.

2. The building plans for the construction
of a new facility or the remodeling of an existing facility must be submitted
to the Division for review before commencement of actual construction. Review
of the plans does not constitute approval of an application for a license.

1. Except as otherwise provided in this
subsection, subsection 3 and NRS
432A.078, in each facility there must be:

(a) At least 35 square feet of indoor space for
each child, exclusive of bathrooms, halls, kitchen, stairs, storage spaces,
multipurpose rooms and gymnasiums that are not regularly used.

(b) At least 37 1/2 square feet of outdoor play
space for each child, as determined by the maximum number of children stated on
the license for the facility. An accommodation facility need not provide
outdoor play space.

2. Each facility shall:

(a) Ensure that each room of the facility which is
used by children is:

(1) Maintained free of drafts and at a
temperature that is not less than 65 degrees Fahrenheit and not more than 82
degrees Fahrenheit during the months of October through March and at a
temperature that is not less than 68 degrees Fahrenheit and not more than 82
degrees Fahrenheit during the months of April through September; and

(2) Heated, cooled and ventilated to maintain
the temperatures required in this paragraph and to avoid the accumulation of
odors and fumes;

(b) Ensure that electrical devices or electrical
apparatuses which are accessible to children are not located near any type of
water source, including, without limitation, any sink, tub, shower area or
wading pool; and

(c) Install nonflammable barriers, including,
without limitation, permanent guards or shields to cover heating units,
including, without limitation, hot water heating pipes and baseboard heaters
with a surface temperature that is hotter than 100 degrees Fahrenheit, to
ensure that those heating units are inaccessible to children.

3. A facility that provides care for ill
children must have:

(a) At least 50 square feet of indoor space for
each child, as determined by the maximum number of children stated on the
license for the facility, exclusive of bathrooms, halls, kitchen, stairs and
storage spaces.

(b) A separate ventilation system if the facility
is attached to another building.

4. The play area of each facility must:

(a) Be fenced or enclosed in a manner that prevents
the unsupervised departure of children from the area;

(b) Have an adequate drainage system;

(c) Be free of hazards, debris and trash;

(d) If it is an outdoor play area, provide, during
the months of April through September, a shade area or shade areas that are at
least equal in size to the product of 5 square feet multiplied by the total
number of children in the outdoor play area;

(e) Have appropriate, as determined by the
Division, depths and perimeters of resilient surfacing underneath and
surrounding any elevated play equipment;

(f) Have adequate safety barriers around any
elevated platforms;

(g) Not have any dangerous or poisonous plants or
other vegetative matter located within the boundaries of the play area or in an
area that is accessible to children from the play area;

(h) Not be in a location where any bodies of water
are accessible to children; and

(i) If it has playground equipment, have only
equipment that is:

(1) In good repair;

(2) Designed and constructed to minimize
injury;

(3) Compatible with the age of the children in
the care of the facility;

(4) Spaced to reduce accidents; and

(5) Securely anchored.

5. If a facility that provides care for ill
children is a component of a child care center and provides outdoor play space,
the play space must:

The regulation of the Board for Child Care filed with
the Secretary of State on April 23, 2009 (LCB File No. R032-07), which amended
this section, contains the following provision not included in NAC:

“1. A child care facility is exempt from
the provisions of paragraph (e) of subsection 4 of NAC
432A.250, as amended by section 9 of this regulation, until the date for
compliance with those provisions established by the Bureau of Services for
Child Care of the Division of Child and Family Services of the Department of
Health and Human Services [now the Division of Public and Behavioral Health] or
an agency for the licensing of child care facilities established by a county or
city, as applicable.

2. As used in this section, “child care
facility” has the meaning ascribed to it in NAC
432A.060.”

1. Each facility shall ensure that weapons,
including, without limitation, firearms, air rifles, bows, hunting knives or
hunting slingshots, are not transported in any vehicle of the facility in which
children are riding unless the weapons are made inoperable and inaccessible.

2. A licensee of a family home or group home
shall ensure that any weapons in the facility are unstrung and unloaded at all
times when children are in the facility.

3. A licensee of a family home or group home
shall ensure that any weapons in the facility are either stored in locked
containers or rooms that are out of the reach of children or are made
inoperable.

4. A licensee of a family home or group home
shall ensure that any ammunition and arrows in the facility are stored in
separate locked containers.

5. Except as otherwise provided in this
subsection and NRS 202.3673,
weapons are prohibited in any child care center, child care institution or
facility for special events. The provisions of this subsection do not apply to
a weapon carried by a peace officer or other law enforcement personnel
certified by the Peace Officers’ Standards and Training Commission pursuant to NRS 289.550.

1. To maintain his or her license, the
licensee must ensure that his or her facility meets all standards for
environmental health which are established by the Bureau of Health Protection
Services of the Division.

2. Reports of inspections concerning the
sanitation of a facility must be maintained in a physical file at the facility
and available for review at the facility by a parent of a child who attends the
facility or a parent who is considering enrolling a child at the facility for
at least 2 years after the date of the inspection.

1. Each facility shall ensure that any
immunizations recommended by a veterinarian for a pet kept at the facility are
up-to-date, regardless of whether the pet is kept inside or outside the
facility.

2. Pets are only permitted in a facility if
they are:

(a) In good health, present no problems of
sanitation and have a temperament which is not hazardous or frightening to
children;

(b) Handled in a manner which protects the
well-being of the children and the pet;

(c) Inoculated as often as prescribed by a
veterinarian; and

(d) Restricted from areas where food is prepared
and from eating areas while meals are being served as required by state and
local health agencies.

3. Each facility shall ensure that any
litter boxes are kept out of the reach of young children and that play areas
are cleaned of all animal feces before children are allowed access to those
areas.

(Added to NAC by Bd. for Child Care by R112-06, eff. 4-23-2009)

NAC 432A.270Advertising. (NRS 432A.077)All
advertising by a licensee of a facility must specify the type of facility for
which it is licensed and must not mislead the public regarding regular programs
and services offered by the licensee.

1. Each licensee shall develop an
appropriate plan to ensure that the staff of his or her facility is prepared to
respond in an emergency, including, without limitation, a fire or natural
disaster. The plan must, at a minimum, be reviewed on a quarterly basis during
a meeting of the staff of the facility. Each licensee shall ensure that the
plan is, at a minimum, evaluated annually and is changed as necessary.

2. Each plan developed pursuant to
subsection 1 must include, without limitation:

(a) The duties of the director and staff;

(b) A procedure for removing staff and children to
a shelter within a building of the facility if the staff and children are
instructed to do so by emergency personnel;

(c) A procedure for evacuating the facility;

(d) A plan for transportation;

(e) A list of sites that may be used for
relocation;

(f) A plan for the supervision of the children of
the facility during the emergency;

(g) The manner in which children and staff from the
facility will be accounted for during the emergency; and

(h) The method for contacting emergency personnel,
including, without limitation, the fire department, a law enforcement agency or
any other appropriate authority.

3. The licensee of a facility shall hold:

(a) A fire drill at least once every month; and

(b) A drill for natural disasters at least once
every 3 months.

4. Appropriate plans for removing the staff
and children of a facility to a shelter within a building of the facility and
for the evacuation of the facility in case of emergency must be conspicuously
posted in a public place in the facility.

5. The director of the facility shall
maintain a daily sign-in sheet that includes:

(a) The first and last names of staff and children;
and

(b) The times of arrival and departure for staff
and children.

6. To maintain his or her license, the
licensee must ensure that his or her facility meets all standards for fire
safety which are established by the State Fire Marshal.

7. The State Fire Marshal or a designee
thereof shall, at least annually:

(a) Enter and inspect every building or the
premises of each facility; and

(b) Observe and make recommendations regarding the
drills conducted pursuant to subsection 3.

8. Reports of the drills conducted pursuant
to subsection 3 and the inspections concerning the fire safety of a facility
conducted pursuant to subsection 7 must be maintained in a physical file at the
facility and be available for review at the facility by a parent of a child who
attends the facility or a parent who is considering enrolling his or her child
at the facility for at least 2 years after the date of inspection.

NAC 432A.290Telephones; insurance for protection against liability to third
persons; transportation. (NRS 432A.077)

1. Each licensee of a facility shall have a
working telephone listed in a local telephone directory. A current list of
emergency telephone numbers, including health agencies, fire and police
departments and ambulance services must be posted adjacent to the telephone.

2. Each licensee of a facility shall have a
policy of insurance for protection against liability to third persons. A
certificate of insurance must be furnished by the licensee of a facility to the
Division as evidence that the policy is in force. Each policy must contain a
provision which requires the insurer to notify the Division at least 30 days
before cancellation or nonrenewal of the policy. The licensee shall notify the
Division if there is a lapse in the insurance coverage required by this
subsection. The policy of insurance must be maintained at the facility. Any
government, governmental agency or political subdivision of a government which
operates a child care facility and is self-insured is not required to furnish a
certificate of insurance to the Division.

3. If transportation is provided by the licensee
of a facility, all children must be protected by adequate supervision by the
staff, safety precautions and adequate insurance which covers liability for
health or injury, medical expenses and damages caused by uninsured motorists.
The licensee of a facility shall require that each child is instructed in the
conduct required for safe transportation. A driver of a vehicle used by the
licensee of a facility shall:

(a) Possess an appropriate driver’s license and
adequate insurance;

(b) Not leave an unattended child in the vehicle at
any time;

(c) Ensure that a parent, or a person designated in
writing by the parent, is present to take charge of a child upon delivery of
the child to his or her home or the facility;

(d) Ensure that each child boards or departs the
vehicle on the side of the vehicle adjacent to a curb and that the child is
safely conducted across any street encountered immediately before boarding or
after departing; and

(e) Ensure that the doors and windows of the
vehicle are secure before proceeding.

4. Except as otherwise provided in this
section and NAC 432A.532, when transporting children,
the licensee of a facility shall ensure that the ratio of caregivers to
children in the vehicle satisfies the applicable requirement for the ratio of
caregivers to children set forth in NAC 432A.524.
When transporting children who are 2 years of age or older, a licensee of a
special needs facility shall ensure that the ratio of caregivers to children in
the vehicle satisfies the applicable requirement for the ratio of caregivers to
children set forth in NAC 432A.532.

5. If, during the time school is in
operation, the licensee of a facility provides transportation for children of
school age to and from a public or private school, the ratio of staff to
children in the vehicle must be not less than one member of the staff for every
15 children.

6. The licensee of a facility shall maintain
a log for transportation provided by the licensee of the facility. The log must
be maintained at the facility for at least 4 months after the transportation is
provided. The log must include:

(a) The name of each child who was transported;

(b) The date the transportation was provided by the
licensee of the facility;

(c) The time of departure of the vehicle and the
time the vehicle arrived at its destination;

(d) The signature of the driver of the vehicle;

(e) The name of each adult who was transported in
the vehicle, including, without limitation, the driver of the vehicle; and

(f) The signed verification required by subsection
7.

7. Upon arrival at the destination, one
member of the staff of the facility shall mark each child off the log as the
child departs the vehicle, conduct a physical inspection and visually and
physically sweep the vehicle to ensure a child is not left behind in the
vehicle, and include in the log signed verification that each child who was
transported in the vehicle is accounted for and that the visual and physical
sweeps were conducted.

1. The licensee of a child care facility
other than a facility that provides care for ill children, an accommodation
facility, a special needs facility or a family or group home shall:

(a) Serve as the director of the facility, if the
licensee has the qualifications of a director; or

(b) Appoint a suitably qualified person to serve as
the director.

2. The director of such a facility must be
at least 21 years of age and, except as otherwise provided in NAC 432A.485:

(a) Have earned a bachelor’s or associate’s degree
and have completed at least 12 semester hours of education, of which:

(1) At least 6 semester hours are in child
development; and

(2) At least 6 semester hours are in child
development, child psychology, education related to the health of children or
in courses directly related to these fields, of which not more than 3 semester
hours may be in courses concerning the business of child care,

Ê and have at
least 6 months of verifiable experience which is satisfactory to the Division
in a program related to child education, early childhood development or child
care;

(b) Have earned a high school diploma or, if
approved by the Administrator of the Division, a certificate based on general
educational development, and have completed at least 12 semester hours of
education, of which:

(1) At least 6 semester hours are in child
development; and

(2) At least 6 semester hours are in child
development, child psychology, education related to the health of children or
in courses directly related to these fields, of which not more than 3 semester
hours may be in courses concerning the business of child care,

Ê and have at
least 2 years of verifiable, satisfactory experience in a program related to
child education, early childhood development or child care;

(c) Have a current credential as a “Child
Development Associate,” which has been issued by the Council for Early
Childhood Professional Recognition, Washington, D.C. 20005; or

(d) Have a combination of education and experience
which, in the judgment of the Administrator of the Division, is equivalent to
that required by paragraph (a), (b) or (c).

3. Before a license is issued to a person to
operate any child care facility for which a director is required, the person
must submit a completed application for approval of the director. The
application must be made on a form supplied by the Division. The applicant must
sign an authorization which gives the Division permission to verify any
information given in the application.

The regulation of the Board for Child Care filed with
the Secretary of State on June 10, 1998 (LCB File No. R047-98), contains the
following provisions not included in NAC regarding the amendment of this
section by LCB File No. R203-97:

“1. A person who was approved before
April 1, 1998, as:

(a) Director of a facility for which a director
is required other than an accommodation facility or a family or group home;

(b) Director of a nursery for infants and
toddlers;

(c) Program director of a preschool; or

(d) Director of a special needs facility,

Ê is not
required to satisfy the amendatory provisions regarding the qualifications of
directors set forth in LCB File No. R203-97, which was adopted by the Board for
Child Care and was filed with the Secretary of State on April 1, 1998, so long
as the person remains at the facility in that capacity.

2. If the person wishes to become
director of a different facility or of a different program within his current
facility, he must satisfy the amendatory provisions regarding the
qualifications of directors set forth in LCB File No. R203-97, which was
adopted by the Board for Child Care and was filed with the Secretary of State
on April 1, 1998.”

1. A licensee of a child care facility shall
not knowingly appoint a person as director of the facility or appoint or permit
the appointment of a person as an employee or volunteer at the facility if the
person has been convicted of child abuse or neglect or any other crime
involving physical harm to a person or if a criminal action for such a crime is
pending against the person.

2. The staff of a child care facility must
be able to:

(a) Work with children without recourse to physical
punishment or psychological abuse;

(b) Communicate with children and their parents;

(c) Praise and encourage children and provide them
with a variety of opportunities for learning and social experiences; and

(2) A copy of the documentation concerning,
and the results of, the investigation of the employee’s background and personal
history which is conducted pursuant to NRS 432A.170, including, without
limitation, a clearance letter from the Division or a current child care work
card, and a release form for this information completed by the employee.

(d) Ensure that each member of the staff of the
facility who is not a caregiver, but whose job duties may directly impact
children cared for in the facility, has the training necessary to protect the
health and safety of the children and the health and safety of the other
members of the staff, including, without limitation, training concerning proper
nutrition, methods of sanitation and procedures for maintaining a safe
environment in the facility.

(e) Work with parents and include them, whenever
possible, in the programming and functioning of activities.

(f) Cooperate with the Division and other agencies
of government to improve the quality of child care and the competence of
caregivers.

(g) Designate a member of the staff who is
responsible for the operation of the facility when the director is not present
at the facility.

3. If the facility is in operation 25 hours
or less, the director must be present in the facility during at least half the
hours of operation.

(c) Be emotionally and physically qualified to
carry out a program which places emphasis on the development of children; and

(d) Except as otherwise provided in subsection 5,
within 90 days after the caregiver commences employment in the child care
facility, apply with The Nevada Registry or its successor organization, and
annually renew his or her registration before the date on which it expires.

2. Not more than 50 percent of the
caregivers in a child care center, a child care institution or an early care
and education program may be under 18 years of age. Any caregiver who is under
18 years of age and is employed in such a facility must:

(a) Have completed a course in the development of
children which is approved by:

(1) The Nevada Registry or its successor
organization, or any other agency designated by the Director of the Department
to approve such courses; or

(2) If the course has not been approved by The
Nevada Registry or its successor organization, and the Director of the
Department has not designated another agency to approve such courses, the
Division or the local licensing agency; or

(b) Be currently enrolled in such a course.

3. A child care facility may not be operated
unless a person who is 18 years of age or older is on the premises of the
facility.

4. A volunteer for a child care facility,
regardless of his or her age, and a member of the staff of the facility who is
under 18 years of age may not provide direct care to a child at the facility
unless the care is provided under the supervision of an employee of the
facility who is 18 years of age or older.

5. A caregiver in a child care institution
is not required to initially apply with or annually renew his or her
registration with The Nevada Registry or its successor organization.

The regulation of the Board for Child Care filed with
the Secretary of State on July 1, 2004 (LCB File No. R203-03), which amended
this section, contains the following provisions not included in NAC:

“Sec. 19. 1. Each
person who, on July 1, 2004, is employed in a child care facility, other than
in an accommodation facility or a facility that provides care for ill children,
or is required pursuant to the amendatory provisions of NAC
432A.320 to satisfy the training and certification requirements set forth
in NAC 432A.323 and section 3 of this regulation [NAC 432A.322], shall:

(a) Complete the 9 hours of training required
pursuant to the amendatory provisions of NAC 432A.320
or subsection 1 of NAC 432A.323; and

(b) Obtain the certification in the
administration of cardiopulmonary resuscitation required pursuant to the
provisions of NAC 432A.320 or section 3 of this
regulation [NAC 432A.322],

Ê within 12
months after July 1, 2004, unless the person has completed the training within
the 12 months before July 1, 2004, or unless on July 1, 2004, the person is
certified in the administration of cardiopulmonary resuscitation and that
certification satisfies the requirements set forth in section 3 of this
regulation [NAC 432A.322].

2. Evidence that such a person has
completed the training required pursuant to subsection 1 and has obtained
certification in the administration of cardiopulmonary resuscitation as
required pursuant to subsection 1 must be included in his personnel file and
must be kept at the facility.

3. With regard to training concerning the
administration of first aid and the recognition of signs and symptoms of
illness that is required pursuant to the amendatory provisions of NAC 432A.323, the evidence listed in NAC 432A.308 as adequate evidence of compliance is
adequate evidence of compliance for the purposes of this section.

Sec. 20. Each person who on July 1,
2004, is a director or licensee of a child care facility or is a caretaker
employed in a child care facility shall, within 12 months after July 1, 2004,
and in addition to completing any training required pursuant to section 19 of
this regulation and completing any course in the development of children
required pursuant to NAC 432A.306, complete at
least:

1. Three hours of training by completing
a course in the development of children; and

2. Three hours of training in child care,

Ê
unless the person has completed the training within the 12 months before July
1, 2004.”

The regulation of the Board for Child Care filed with
the Secretary of State on April 23, 2009 (LCB File No. 112-06), which amended
this section, contains the following provision not included in NAC:

“1. Except as otherwise provided in
subsection 2, each caregiver who, on the effective date of this section [April
23, 2009], is a caregiver employed in a child care facility other than a
caregiver who is employed in an accommodation facility, a facility that
provides care for ill children or a child care institution shall, on or before
December 31, 2012, apply with The Nevada Registry or its successor
organization.

2. Each caregiver who, on the effective
date of this section [April 23, 2009], is a caregiver employed in a family home
or in a group home shall, on or before December 31, 2011, apply with The Nevada
Registry or its successor organization.

3. As used in this section:

(a) “Accommodation facility” has the meaning
ascribed to it in NAC 432A.012, as amended by
section 22 of this regulation.

(b) “Caregiver” has the meaning ascribed to it
in NAC 432A.020, as amended by section 23 of this
regulation.

(c) “Child care center” has the meaning ascribed
to it in NAC 432A.050, as amended by section 24 of
this regulation.

(d) “Child care facility” has the meaning
ascribed to it in NAC 432A.060.

(e) “Child care institution” has the meaning
ascribed to it in NAC 432A.070, as amended by
section 25 of this regulation.

(i) “The Nevada Registry” has the meaning
ascribed to it in section 7 of this regulation [NAC
432A.143].”

NAC 432A.308Completion by caregiver of training for recognition of signs and
symptoms of illness and administration of first aid. (NRS 432A.077)

1. Whenever a child care facility is in
operation, each caregiver on duty must have completed training for the
recognition of signs and symptoms of illness and the administration of first
aid.

2. The training for the recognition of signs
and symptoms of illness must include, without limitation, the provision of
information concerning health and the observation and evaluation of signs and
symptoms of illness and responses to illness and emergencies and training in
the prevention of exposure to bloodborne pathogens. The training for the
administration of first aid must include, without limitation, the
administration of first aid to victims of fire, serious injury or the ingestion
of poison. Both types of training must be:

(a) Provided by a licensed health care professional
or a representative of a licensed health care agency or clinic, a community
college, a university, the American National Red Cross, an adult education
program in home nursing or an institution approved by The Nevada Registry or
its successor organization; and

(b) Approved by:

(1) The Nevada Registry or its successor
organization, or any other agency designated by the Director of the Department
to approve the training; or

(2) If the training is not approved by The
Nevada Registry or its successor organization, and the Director of the
Department has not designated another agency to approve the training, the
Division or the local licensing agency.

3. A certificate or other evidence of
compliance issued by a licensed health care professional, a licensed health
care agency or clinic, a community college, a university, the American National
Red Cross, an adult education program in home nursing or an approved provider
of such training is adequate evidence of compliance.

(Added to NAC by Bd. for Child Care, eff. 6-5-84; A by
R203-03, 7-1-2004; R112-06, 4-23-2009)

1. Every member of the staff of a facility,
including a volunteer, shall present to the director of the facility, to be
placed in the employee’s file, written evidence that the employee is free from
communicable tuberculosis. The evidence must be in the form of a report which
states that the employee is free from active tuberculosis as required pursuant
to subsection 2 or 3.

2. Before a person, including a person who
has received a bacillus Calmette-Guerin (BCG) vaccination, begins employment at
a facility, he or she must have submitted to a:

(a) Mantoux tuberculin skin test; or

(b) Chest radiograph and examination by a provider
of health care who is authorized to diagnose active tuberculosis,

Ê within the 12
months immediately preceding the first day of employment at the facility.

3. Every member of the staff of a facility,
including a volunteer, shall submit to:

(a) A Mantoux tuberculin skin test; or

(b) An examination by a provider of health care who
is authorized to diagnose active tuberculosis,

Ê at least once
every 24 months after the date the skin test or chest radiograph and
examination were conducted pursuant to subsection 2.

4. Each caregiver or member of the staff of
a facility who has an identified health problem that may affect his or her
ability to provide adequate care to children in a facility shall:

(a) Report the problem to the director of the
facility or, if self-employed, to his or her licensing agency; and

(b) Submit to the director or, if self-employed, to
his or her licensing agency, a written statement from a licensed physician
attesting to the fact that the health of the caregiver does not endanger the
children who are under his or her care in the facility.

5. Each director shall report to his or her
licensing agency any health problem reported to him or her pursuant to
subsection 4.

6. Each director or caregiver, if
self-employed, shall immediately report to his or her licensing agency any
person residing at his or her facility who contracts a serious communicable
disease.

7. Each caregiver or member of the staff of
a facility who has herpetic gingivostomatitis, a cold sore or herpes labialis
shall:

(a) Refrain from engaging in close contact with
children cared for in the facility;

(b) Refrain from sharing food or drink with
children cared for in the facility or with other caregivers or members of the
staff of the facility;

(c) Avoid touching the lesions;

(d) Wash his or her hands frequently; and

(e) Cover any skin lesion with a bandage, clothing
or other appropriate dressing.

1. Except as otherwise provided in NRS 432A.177, within the first 2
weeks after commencing employment, newly employed members of the staff of a
facility must be given a written and oral orientation program and be trained in
the policies, procedures and programs of the facility by the director or a
designee trained by the director. The orientation must address, at a minimum:

(a) Any regulatory requirements that govern the
facility;

(b) The goals and philosophy and the policies and
procedures of the facility;

(c) Any planned programs or activities of the
facility;

(d) The policies and practices of the facility for
relating to parents;

(e) Meal patterns and food-handling policies and
practices of the facility;

(f) Dealing with occupational health hazards for
caregivers, including, without limitation, paying attention to the physical
health and emotional demands of the job and being aware of any special
considerations required by a caregiver who is pregnant;

(g) The emergency health and safety procedures of
the facility; and

(h) The general health and safety policies and
procedures of the facility, including, without limitation, policies and procedures
concerning:

(1) Hand-washing techniques and requirements;

(2) Techniques for diapering and for assisting
in the use of a toilet if care is provided to children in diapers or children
needing help with using a toilet, including, without limitation, techniques for
the disposal of diapers and for changing diapers;

(3) Identifying hazards and methods for
preventing injuries;

(4) Techniques for preparing, serving and
storing food for employees who are involved in any of the activities concerning
food for children at the facility;

(5) Excluding a child from the facility
because the child has an illness, and the manner in which illnesses are
transmitted between persons;

(6) Methods for preparing formula if formula
is prepared at the facility;

(7) Any precautions and other measures that
should be taken to prevent exposure to blood and other bodily fluids, and
policies and procedures to follow in the event of exposure to blood or other
bodily fluids; and

(8) The administration of medication.

2. If required by the director or owner of
the facility, a member of the staff of a facility shall participate in any
specialized training related to child care which is offered in the community
where the facility is located.

3. A volunteer who works at least 15 hours
per week in a facility and participates in specialized child care training, as
defined by the director:

(a) Is a member of the staff of the facility for
the purposes of this section; and

(b) Must satisfy the training and certification
requirements set forth in NAC 432A.323 and 432A.326.

4. Any training received by an employee of a
facility or a volunteer who works in a facility as part of the orientation
required by this section may not be applied toward meeting the training
requirements set forth in NAC 432A.323 and 432A.326.

The regulation of the Board for Child Care filed with
the Secretary of State on July 1, 2004 (LCB File No. R203-03), which amended
this section, contains the following provisions not included in NAC:

“Sec. 19. 1. Each
person who, on July 1, 2004, is employed in a child care facility, other than
in an accommodation facility or a facility that provides care for ill children,
or is required pursuant to the amendatory provisions of NAC
432A.320 to satisfy the training and certification requirements set forth
in NAC 432A.323 and section 3 of this regulation [NAC 432A.322], shall:

(a) Complete the 9 hours of training required
pursuant to the amendatory provisions of NAC 432A.320
or subsection 1 of NAC 432A.323; and

(b) Obtain the certification in the
administration of cardiopulmonary resuscitation required pursuant to the
provisions of NAC 432A.320 or section 3 of this
regulation [NAC 432A.322],

Ê within 12
months after July 1, 2004, unless the person has completed the training within
the 12 months before July 1, 2004, or unless on July 1, 2004, the person is
certified in the administration of cardiopulmonary resuscitation and that
certification satisfies the requirements set forth in section 3 of this
regulation [NAC 432A.322].

2. Evidence that such a person has
completed the training required pursuant to subsection 1 and has obtained
certification in the administration of cardiopulmonary resuscitation as
required pursuant to subsection 1 must be included in his personnel file and
must be kept at the facility.

3. With regard to training concerning the
administration of first aid and the recognition of signs and symptoms of
illness that is required pursuant to the amendatory provisions of NAC 432A.323, the evidence listed in NAC 432A.308 as adequate evidence of compliance is
adequate evidence of compliance for the purposes of this section.

Sec. 20. Each person who on July 1,
2004, is a director or licensee of a child care facility or is a caretaker
employed in a child care facility shall, within 12 months after July 1, 2004,
and in addition to completing any training required pursuant to section 19 of
this regulation and completing any course in the development of children
required pursuant to NAC 432A.306, complete at
least:

1. Three hours of training by completing
a course in the development of children; and

2. Three hours of training in child care,

Ê unless the
person has completed the training within the 12 months before July 1, 2004.”

NAC 432A.321Training of employees who have direct contact with children in
physical custody due to court order. (NRS 432A.077, 432A.177)

1. The training required pursuant to NRS 432A.177 must be approved by:

(a) An agency designated by the Director of the
Department to approve such training; or

(b) If the Director has not designated an agency to
approve the training, the Division or the local licensing agency.

2. The licensee of a child care facility
shall:

(a) Include evidence of completion of the training
required pursuant to NRS 432A.177
in the personnel file of each employee of the child care facility required to
complete the training; and

(b) Upon request of the Division, submit the
evidence of completion of the training for any employee of the child care
facility required to complete such training.

(a) Except as otherwise provided in subsection 2
and NAC 432A.560 and 432A.570,
obtain certification in the administration of cardiopulmonary resuscitation
within 90 days after the person commences employment in the facility; and

(b) Maintain current certification in the
administration of cardiopulmonary resuscitation.

2. A person is not required to obtain the
certification required pursuant to subsection 1 if, on the date that he or she
commences employment in the facility, the person is certified in the
administration of cardiopulmonary resuscitation and that certification
satisfies the requirements set forth in this section.

3. The certification required pursuant to
subsection 1 must include certification in administering cardiopulmonary
resuscitation to children and:

(a) To infants, if care is provided to infants at
the facility; and

(b) To adults, if necessary to ensure that the
person is certified to administer cardiopulmonary resuscitation to children of
all ages for which care is provided at the facility.

4. Each course completed to obtain and
maintain the certification required pursuant to subsection 1 must be taught by
a certified instructor who meets the standards of a nationally or
internationally recognized provider of training in cardiopulmonary
resuscitation, including, without limitation, the American Heart Association,
the American National Red Cross, MEDIC FIRST AID International, EMS Safety
Services, or the American Safety and Health Institute.

5. Evidence that an employee has obtained
and maintained current certification in the administration of cardiopulmonary
resuscitation as required pursuant to this section must be included in his or
her personnel file and must be kept at the facility.

(Added to NAC by Bd. for Child Care, eff. 7-1-2004; A
by R032-07, 4-23-2009)

REVISER’S NOTE.

The regulation of the Board for Child Care filed with
the Secretary of State on July 1, 2004 (LCB File No. R203-03), the source of
this section (section 3 of the regulation), contains the following provisions
not included in NAC:

“1. Each person who, on July 1, 2004, is
employed in a child care facility, other than in an accommodation facility or a
facility that provides care for ill children, or is required pursuant to the
amendatory provisions of NAC 432A.320 to satisfy
the training and certification requirements set forth in NAC 432A.323 and section 3 of this regulation [NAC 432A.322], shall:

(a) Complete the 9 hours of training required
pursuant to the amendatory provisions of NAC 432A.320
or subsection 1 of NAC 432A.323; and

(b) Obtain the certification in the
administration of cardiopulmonary resuscitation required pursuant to the
provisions of NAC 432A.320 or section 3 of this
regulation [NAC 432A.322],

Ê within 12
months after July 1, 2004, unless the person has completed the training within
the 12 months before July 1, 2004, or unless on July 1, 2004, the person is
certified in the administration of cardiopulmonary resuscitation and that
certification satisfies the requirements set forth in section 3 of this
regulation [NAC 432A.322].

2. Evidence that such a person has
completed the training required pursuant to subsection 1 and has obtained
certification in the administration of cardiopulmonary resuscitation as
required pursuant to subsection 1 must be included in his personnel file and
must be kept at the facility.

3. With regard to training concerning the
administration of first aid and the recognition of signs and symptoms of
illness that is required pursuant to the amendatory provisions of NAC 432A.323, the evidence listed in NAC 432A.308 as adequate evidence of compliance is
adequate evidence of compliance for the purposes of this section.”

1. Except as otherwise provided in subsection
4 and NAC 432A.521 and NRS 432A.177, within 90 days
after commencing his or her employment or position in a child care facility,
each person who is employed in a child care facility, other than a person
employed in a facility that provides care for ill children, and each director
of a child care facility shall complete:

(a) Any training required by the facility in which
the director serves or in which the person is employed for the purposes of
obtaining certification in the administration of cardiopulmonary resuscitation
as required pursuant to NAC 432A.322;

(b) Three or more hours of training in child
development or guidance and discipline specific to the age group served by the
facility in which the director serves or in which the person is employed;

(c) Two or more hours of training in the
administration of first aid;

(d) Two or more hours of training in the
recognition of signs and symptoms of illness, which must include, without
limitation, training in the prevention of exposure to bloodborne pathogens;

(e) Two or more hours of training in the
recognition and reporting of child abuse and neglect; and

(f) If the person or director works with infants
under 12 months of age, at least 2 hours of training concerning Sudden Infant
Death Syndrome.

2. Except as otherwise provided in NAC 432A.521, within 12 months after commencing
employment, each person described in subsection 1 shall, in addition to
completing any training required pursuant to subsection 1 and completing any
course in the development of children required pursuant to NAC 432A.306, complete at least 15 hours of training
in professional development as required pursuant to NAC
432A.326.

3. Except as otherwise provided in NAC 432A.521, within 12 months after commencing
employment as a member of the staff of a facility, each member of the staff of
a facility who works in a nursery for infants and toddlers shall, in addition
to completing any training required pursuant to subsections 1 and 2, and
completing any course in the development of children required pursuant to NAC 432A.306, complete at least 2 hours of training
concerning Sudden Infant Death Syndrome.

4. A new employee of a child care facility
is not required to complete the training required pursuant to subsection 1 if
he or she has completed that training within the previous 24 months.

5. The training concerning the
administration of first aid and the recognition of signs and symptoms of
illness that is required to be completed pursuant to subsection 1 must be
provided by one of the persons, agencies or institutions listed in NAC 432A.308 as qualified to provide such training.

6. The training required pursuant to
subsections 1, 2 and 3 must be designed to:

(a) Ensure the protection of the health and safety
of each child enrolled in the facility; and

(b) Promote the physical, moral and mental
well-being of each child enrolled in the facility.

7. If the facility is a special needs
facility, the training required pursuant to subsections 1, 2 and 3 must also be
designed to provide information on the characteristics of handicapping
conditions and appropriate programs for children with special needs. The
training must be approved by:

(a) The Nevada Registry or its successor
organization, or any other agency designated by the Director of the Department
to approve such training; or

(b) If the training has not been approved by The
Nevada Registry or its successor organization, and the Director of the
Department has not designated another agency to approve such courses, the
Division or the local licensing agency.

8. Evidence that an employee has completed
the training required pursuant to subsections 1, 2 and 3 must be included in
his or her personnel file and must be kept at the facility. With regard to
training concerning the administration of first aid and the recognition of
signs and symptoms of illness, the evidence listed in NAC
432A.308 as adequate evidence of compliance is adequate evidence of
compliance for the purposes of this section.

The regulation of the Board for Child Care filed with
the Secretary of State on July 1, 2004 (LCB File No. R203-03), which amended
this section, contains the following provisions not included in NAC:

“Sec. 19. 1. Each
person who, on July 1, 2004, is employed in a child care facility, other than
in an accommodation facility or a facility that provides care for ill children,
or is required pursuant to the amendatory provisions of NAC
432A.320 to satisfy the training and certification requirements set forth
in NAC 432A.323 and section 3 of this regulation [NAC 432A.322], shall:

(a) Complete the 9 hours of training required
pursuant to the amendatory provisions of NAC 432A.320
or subsection 1 of NAC 432A.323; and

(b) Obtain the certification in the
administration of cardiopulmonary resuscitation required pursuant to the
provisions of NAC 432A.320 or section 3 of this
regulation [NAC 432A.322],

Ê within 12
months after July 1, 2004, unless the person has completed the training within
the 12 months before July 1, 2004, or unless on July 1, 2004, the person is
certified in the administration of cardiopulmonary resuscitation and that
certification satisfies the requirements set forth in section 3 of this
regulation [NAC 432A.322].

2. Evidence that such a person has
completed the training required pursuant to subsection 1 and has obtained
certification in the administration of cardiopulmonary resuscitation as
required pursuant to subsection 1 must be included in his personnel file and
must be kept at the facility.

3. With regard to training concerning the
administration of first aid and the recognition of signs and symptoms of
illness that is required pursuant to the amendatory provisions of NAC 432A.323, the evidence listed in NAC 432A.308 as adequate evidence of compliance is
adequate evidence of compliance for the purposes of this section.

Sec. 20. Each person who on July 1,
2004, is a director or licensee of a child care facility or is a caretaker
employed in a child care facility shall, within 12 months after July 1, 2004,
and in addition to completing any training required pursuant to section 19 of
this regulation and completing any course in the development of children
required pursuant to NAC 432A.306, complete at
least:

1. Three hours of training by completing
a course in the development of children; and

2. Three hours of training in child care,

Ê unless the
person has completed the training within the 12 months before July 1, 2004.”

1. During each 12-month period immediately
succeeding the completion of the initial training required pursuant to NAC 432A.323, each director of a child care facility
and each caregiver who is employed at the facility shall complete at least 15
hours of training in professional development, of which not more than 3 hours
may be training in the administration of cardiopulmonary resuscitation. The
required hours of training may consist of:

(a) Informal training, including, without
limitation, on-site training at a facility, community workshops or conferences;

(b) Formal training; or

(c) An early child care and education course
offered by a community college or university.

2. Any training relating to the
administration of cardiopulmonary resuscitation must be taught by a certified
instructor who meets the standards of a nationally or internationally
recognized provider of training in cardiopulmonary resuscitation, including,
without limitation, the American Heart Association, the American National Red
Cross, MEDIC FIRST AID International, EMS Safety Services, or the American
Safety and Health Institute.

3. The training must be approved by:

(a) The Nevada Registry or its successor
organization, or any other agency designated by the Director of the Department
to approve such training; or

(b) If the training has not been approved by The
Nevada Registry or its successor organization, and the Director of the
Department has not designated another agency to approve such courses, the
Division or the local licensing agency.

4. A director or caregiver described in
subsection 1 may not receive credit toward the training required pursuant to
subsection 1 for hours of training received concerning the administration of
first aid or concerning the recognition of signs and symptoms of illness more
than once every 36 months.

NAC 432A.340Information to be provided by parent; maintenance of record for
each child. (NRS 432A.077)

1. Procedures for admission must provide the
caregiver with sufficient information and instruction from the parents to
enable the caregiver to prepare a record and to make decisions or act on behalf
of the child.

2. Before the admission of a child to a
facility, the parent shall give the following information to the caregiver:

(a) The child’s full legal name, date of birth,
current address and preferred name;

(b) The name, address and telephone number of each
parent responsible for the child and any special instructions needed to reach
the parent during the hours the child is in the facility;

(c) The name, address and telephone number of any
person who can assume responsibility for the child and is authorized to take
the child from the facility if the parents cannot be reached;

(d) Information concerning the health of the child,
including any special needs of the child; and

(e) A written authorization signed by a parent
which allows emergency surgical and medical care.

3. The caregiver shall, unless the facility
is an accommodation facility:

(a) Make a record for each child that includes the
date the record was prepared and the date the child is scheduled to attend the
facility; and

(g) Requires written parental permission for trips
and activities outside the facility;

(h) Provides for parental involvement in the
general functions of the facility;

(i) Gives either or both parents the right to
observe the program of the licensee before enrollment and at any time after
enrollment of the child;

(j) For a child care facility as defined in
paragraph (a) of subsection 7 of NRS
202.2491, notifies either or both parents that smoking of tobacco in any
form is prohibited in the facility at all times;

(k) For a facility other than a child care facility
as defined in paragraph (a) of subsection 7 of NRS 202.2491, notifies either or
both parents if smoking of tobacco is permitted on the premises of the facility
in a designated area approved by the fire authority;

(l) Notifies either or both parents if and when a
member of the staff who is trained and certified in cardiopulmonary
resuscitation is on duty at the facility; and

(m) Notifies either or both parents of the contents
of any plan created pursuant to NAC 432A.280 to
ensure that the staff of the facility is prepared to respond to an emergency.

2. In addition to the information required
by subsection 1, a licensee for a facility that provides care for ill children
shall adopt criteria for admission that set forth:

(a) The illnesses and disabilities that are
accepted;

(b) The illnesses and disabilities that are not
accepted;

(c) The ages of children served by the facility;

(d) The information required from a parent before a
child may be admitted to the facility; and

(e) The procedures to be followed by the staff of
the facility in the event of an emergency.

3. Every licensee shall provide a copy of
the statement described in subsection 1 to each paid or volunteer member of its
staff, to each parent of a child enrolled in the facility and to the Division.

4. The name, business address and business
telephone number of any person who has legal or administrative responsibility
for the facility must be provided to each parent of a child enrolled in the
facility and to the Division.

5. The licensee of a facility shall notify
each parent of a child enrolled in the facility and the Division of significant
changes in the services offered by the facility.

1. The licensee of a facility shall not
disclose to any person who is not a member of the staff of the facility or a
member of the licensing staff of the Division information pertaining to any
child, unless:

(a) The parent has given written permission for the
disclosure; or

(b) There is an emergency as determined by the
director or the member of the staff who is in charge at the time of the
emergency.

2. The licensee of a facility shall have
available forms which allow a parent to release information pertaining to his
or her child.

1. Evidence of each child’s health must be
presented to the director of a facility, other than an accommodation facility
or a facility that provides care for ill children, within 30 days after the
child’s initial admission. The evidence must include a written statement from a
licensed physician or registered nurse attesting to the status of the child’s
health and stating that all known special conditions are under treatment and
the child is capable of adjusting to the programs of the facility.

2. A licensee of each such facility shall
keep a record of each child which includes any pertinent information on the
status of the child’s health and any special needs of the child.

1. If a child becomes seriously ill or
injured in a child care facility, other than a facility that provides care for
ill children, the child must be immediately isolated from other children and
placed under appropriate supervision. A parent, a person designated by a parent
or a physician designated by a parent, must be promptly notified and the child
must be removed from the facility as quickly as possible. Members of the staff
of a facility shall not administer any medical treatment, except emergency
first aid and prescribed medications to the child.

2. If a member of the staff transports or
accompanies a child for professional emergency care, he or she shall remain
with the child until the parents assume responsibility for the care of the
child.

(a) Be kept in the original container which must
have a child-proof lid;

(b) Be plainly labeled;

(c) Contain the name of the child or adult for whom
it is prescribed; and

(d) Be stored in a locked cabinet or be made
inaccessible to children.

2. Medications for external use must be kept
in a separate section of the locked cabinet. Medications stored in a
refrigerator must be made inaccessible to children. Nonprescription medications
must be kept in a container with a child-proof lid.

3. Except in an emergency, only one person
designated by the licensee of a facility may administer medications to
children. A person designated by the licensee of a facility pursuant to this
subsection must be trained in the administration of medication by a health care
professional or the parent of a child cared for in the facility and authorized
to administer the medication pursuant to NRS 453.375 or 454.213.

4. The licensee of a facility shall maintain
a written record containing:

(a) The name of each medication administered;

(b) The name of the child to whom it was
administered; and

(c) The date and time on which it was administered
on a weekly basis. The record must be kept in the child’s file.

5. A prescribed medication must, upon
discontinuance of use, be promptly destroyed or returned to the child’s parent.

1. Upon the occurrence of any accident or
injury which requires emergency professional medical care of a child, the
director, operator or owner of each facility shall report the occurrence to the
Division or local licensing agency as soon as possible and shall keep on file
at the facility a report of the occurrence.

2. If the director, operator or owner of a
facility finds that any reportable communicable disease may be present in the
facility, he or she shall report that condition to the Division or local
licensing agency as soon as possible. The Division or local licensing agency
shall provide the list of reportable communicable diseases to all licensees and
applicants.

3. The director, operator or owner of each
facility shall report as soon as possible to the Division or local licensing
agency the death of any child who attends or lives in the facility.

1. To the extent set forth in subsections 3
and 4, a licensee of a facility shall meet the daily nutritional needs of each
child. Meals and snacks must be of a quality and quantity which supplement the
food served at home. Cultural and ethnic foods which are appropriate for
children must be considered in planning meals. To the extent possible,
information provided by parents concerning their child’s eating habits and
preferences or special needs regarding food must be considered in planning for
meals.

2. A licensee of a facility shall consult
the Division or local licensing agency or some other public agency for
nutritional information which is applicable to children of ages receiving care
at the facility.

3. A child who stays in a facility:

(a) For 10 hours or less in 1 day must be offered
at least one meal and two snacks or two meals and one snack; and

(b) For more than 10 hours in 1 day must be offered
at least two meals and two snacks or one meal and three snacks.

4. A nutritious snack must be offered to all
children in the midmorning and the midafternoon. Each child must be offered
food at intervals that are at least 2 hours apart and, unless the child is
asleep during that time, are not more than 3 hours apart.

5. Foods and beverages which are sweet or
have little nutritional value must not be served to children except as an
addition to the meals or snacks served to comply with the requirements of
subsections 3 and 4.

6. Every menu must be in writing, dated,
planned a week in advance, and kept on file in the facility for at least 90
days after the corresponding meal is served. The licensee of a facility shall
post the current menu, including any changes, in the kitchen and in a public
place within the facility convenient for parental inspection. Family homes and
group homes are exempt from the requirements of this subsection.

7. Meals may be brought from home to a
facility for a child to consume at the facility. The bag or other container
used to bring the meal to the facility must be labeled with the child’s first
and last name. A facility shall inform the parents of each child who is cared
for in the facility that perishable items must be stored or packed in a manner
that maintains the temperature of the contents.

8. A child is not allowed in the kitchen of
any facility unless he or she is supervised.

9. Whenever possible, members of the staff
of the facility must eat with the children and encourage them to eat a variety
of food and observe table manners.

10. Drinking water must be freely available
to all children at all times.

11. Food must not be used as a basis for discipline
or reward. Children should be encouraged, but must not be forced, to eat.

NAC 432A.382Restriction on employment of or contracting with person to
provide medical nutrition therapy or nutrition services. (NRS 432A.077)A
licensee shall not employ or contract with a person to provide medical
nutrition therapy or nutrition services unless the person is licensed pursuant
to chapter 640E of NRS or exempt
from such licensure.

(a) Provide appropriate and adequate seating for
the children at the facility during snacks and meals;

(b) If a high chair is used, ensure that the chair:

(1) Is in good condition;

(2) Has a wide base; and

(3) Has a safety belt for the child;

(c) Wash with a detergent and disinfect after each
use any chair or table that is used during a snack or meal;

(d) Allow, encourage and assist each child to feed
himself or herself, including, without limitation, encouraging a child to hold
and drink from a cup, use a spoon and use his or her fingers to feed himself or
herself;

(e) Offer each child drinking water at times other
than during his or her regular feedings;

(f) Discard any food that is left in a dish after a
meal;

(g) Ensure that bottles and containers of food are
not kept in water longer than 5 minutes, and stir, shake and test a bottle or
container of food before using the bottle or container to feed an infant;

(h) Not hold an infant while preparing food;

(i) On a daily basis, empty, clean and sanitize any
pot used to warm a bottle or food;

(j) Store each bottle of formula and container of
food in accordance with the instructions from the manufacturer of the formula
or food;

(k) Label each bottle of formula and container of
food with the name of the child to whom it belongs and the date the formula or
food was prepared by the facility or was prepared or purchased by the parent;

(l) Immediately refrigerate and label each
container of breast milk provided by a parent;

(m) Return each bottle to the appropriate parent
each day;

(n) Return any unused, open container of food to
the appropriate parent each day if the child was not fed directly from the
container of food; and

(o) Develop with the parents of a child a plan for
feeding the child, which must include, without limitation:

(1) Instructions for feeding;

(2) Any special dietary restrictions,
including, without limitation, any allergies to food;

(3) A schedule of times for feeding;

(4) Whether the child will be fed breast milk,
formula or solid food;

(5) If the child will be fed breast milk or
formula, when to begin feeding solid food; and

(6) Likes and dislikes of certain foods.

2. A child who is fed with a bottle and does
not hold his or her own bottle must be held by a caregiver while being fed with
a bottle. The bottle must not be propped for feeding. A child who demonstrates
a preference for holding a bottle during feeding may hold his or her own bottle
and need not be held by a caregiver if the caregiver is directly observing the
child.

3. The staff of a facility may feed a child
commercially prepared baby food directly from the jar in which it was packaged
or from a separate dish. If the staff feeds the child from the jar, the staff
shall discard the jar after it is used.

(Added to NAC by Bd. for Child Care by R203-97, eff. 4-1-98;
A by R047-98, 6-10-98; R072-98, 8-3-98; R112-06, 4-23-2009)

1. Every licensee of a facility shall
develop a program to meet the basic needs of children for:

(a) Good health and normal physical development;

(b) Optimal mental growth;

(c) Stimulating language and communicative
experiences;

(d) The attention, acceptance and affection of
others;

(e) Opportunities to experience success and to test
mental, physical and social skills;

(f) Self-identity and a sense of competence and
worth;

(g) The security provided by gentle discipline;

(h) Relations with others which set forth the
rights of adults and the rights of children;

(i) Learning experiences planned with the aid of
the child’s parents which ensure harmony with the life style and cultural
background of the child;

(j) Activities which facilitate social growth and
adjustment; and

(k) The time and opportunity to learn independence
and personal care.

2. A licensee of a facility shall teach each
child personal hygiene. The licensee of a facility shall require all children
to wash before meals and after using a toilet.

3. If the weather permits, all children must
have a daily period of outdoor play. A licensee of a facility shall provide
opportunities for active play which builds muscles such as climbing, jumping,
running and playing with toys which have wheels. The quantity and quality of
materials and equipment must be sufficient to avoid excessive competition
between the children and long waiting periods to use the materials or
equipment.

4. Every child who is in a facility for more
than 5 hours per day must have a period for a nap during the day. A child who
cannot sleep must rest during the period provided for a nap. The licensee of a
facility shall provide a cot, mat or bed for each child.

5. The amount, variety and arrangement and
use of materials and equipment used in a facility must be appropriate to the
developmental needs of the children cared for in the facility. Materials must
be stored in a manner that allows children to select, remove and replace the
materials independently or with minimal assistance.

6. Furniture must be durable, safe and
intended for use by children or appropriately adapted for use by children.

7. A licensee of a facility shall provide
space for the storage of the children’s clothing and the storage must be within
easy reach of the children.

NAC 432A.410Reports of child abuse or neglect. (NRS
432A.077)If
any person suspects that child abuse or neglect is occurring in a facility, the
person may immediately report such suspicions to the Division. Every licensee
or employee of a facility who has reason to believe child abuse or neglect is
occurring in the facility, in the child’s home or elsewhere shall report such
beliefs to the appropriate authority as required in NRS 432B.220.

(b) Be located within close proximity to a sink
that is not used for the preparation of food;

(c) Not be located in an area in which food is
prepared;

(d) Have a smooth, nonabsorbent floor covering;

(e) Have nearby, for wet or soiled diapers, a
washable receptacle that is lined with plastic and covered with a lid;

(f) Be kept in good repair and in a safe condition;
and

(g) Be cleaned and disinfected after each use by
removing any visible soil and applying an approved disinfectant.

2. Each soiled cloth diaper and any soiled
clothing that may be contaminated with contagious matter must be stored in an
individual plastic bag and be returned to the parents daily. The facility is
not required to rinse or dump the contents of a diaper or the underwear of a
child cared for in the facility. Each diaper used, including, without
limitation, a commercial disposable diaper, must be able to contain urine and
stool and minimize contamination. If cloth diapers are used on children, an
absorbent inner liner and a waterproof outer covering must be provided with the
diaper.

3. The staff of a facility:

(a) Shall discourage children from coming near an
area that is used for changing diapers; and

(b) Shall not leave a child unattended in the
diaper changing area.

(Added to NAC by Bd. for Child Care by R203-97, eff. 4-1-98;
A by R047-98, 6-10-98; R072-98, 8-3-98; R112-06, 4-23-2009)

1. Each facility must have written
procedures concerning the washing of hands.

2. The staff of a facility shall follow the
procedures of the facility concerning the washing of hands and shall instruct,
monitor and assist the children being cared for at the facility to ensure that
the children follow the procedures.

3. The procedures concerning the washing of
hands must require, without limitation, that:

(a) The staff of the facility wash their hands with
soap from a dispenser and warm water:

(1) Any time that their hands come into
contact with blood, mucus, vomit, feces or urine;

(2) Before preparing or handling food;

(3) Before engaging in any activity related to
serving food, including, without limitation, setting the table;

(4) Before and after eating a meal or snack;

(5) After using the toilet, helping a child
use the toilet or changing a diaper with or without gloves;

(6) After attending to an ill child;

(7) After handling an animal;

(8) Before and after giving medication to a
child; and

(9) After cleaning a container used to store
garbage or handling garbage.

(b) The children being cared for in the facility
wash their hands with soap from a dispenser and warm water:

(1) Any time that their hands come into
contact with blood, mucus, vomit, feces or urine;

(2) Before handling food;

(3) Before and after eating a meal or snack;

(4) After handling an animal;

(5) After the diaper or underwear of the child
is changed;

(6) After playing in water; and

(7) After playing in a sandbox.

(c) The staff of the facility shall ensure that:

(1) Each bathroom has running water, soap and
single-use or disposable towels; and

(2) Any common basin or sink which is filled
with standing water is not used for the washing of hands.

(Added to NAC by Bd. for Child Care by R203-97, eff. 4-1-98;
A by R047-98, 6-10-98; R112-06, 4-23-2009)

1. A carpeted floor or rug on a floor that
is too large to wash in a washing machine must be vacuumed not less than one
time each day or more often if necessary and cleaned not less than one time
every 3 months or more often if necessary. If the carpeted floor or rug is
cleaned by a member of the staff of the facility using a carpet cleaning
machine, the Division may require the carpeted floor or rug to be
professionally cleaned if the carpeted floor or rug does not appear to be
clean.

2. Each floor of a facility that is not
carpeted must be swept and mopped not less than one time each day or more often
if necessary.

3. When cleaning a nonporous surface in a
facility, including, without limitation, cleaning toys, cribs, tables, high chairs
and surfaces used to change diapers, the staff of the facility shall:

(a) Clean the surface first with soap and water to
remove any dirt or debris; and

(b) Disinfect the surface with a disinfecting
agent.

4. The disinfecting agent used pursuant to subsection
3 must consist of:

(a) One-fourth of a cup of liquid chlorine bleach
added to 1 gallon of water that is prepared fresh daily and kept in a closed
container;

(b) One tablespoon of liquid chlorine bleach added
to 1 quart of water that is prepared fresh daily; or

(c) A solution that is approved by the appropriate
state or local agency and is at least as effective as the solutions described
in paragraphs (a) and (b).

(Added to NAC by Bd. for Child Care by R203-97, eff. 4-1-98;
A by R047-98, 6-10-98; R072-98, 8-3-98; R112-06, 4-23-2009)

NAC 432A.415Safety and sanitation of toys, equipment and other objects and
material used for play. (NRS 432A.077)

1. Equipment and any material other than a
toy that is used for play in a facility must be durable and free from
characteristics that may be hazardous or injurious to a child who is less than
2 years of age, including, without limitation, such characteristics as sharp or
rough edges, toxic paint or objects that are small enough for a child of that
age to swallow and choke on.

2. Any object, toy or component of a toy
that is accessible by a child who is less than 3 years of age at a facility
must meet the federal size requirements set forth in 16 C.F.R. § 1501.4.

3. Toys with sharp points or edges, plastic
bags and objects made from Styrofoam must not be accessible to a child who is
less than 3 years of age.

4. A toy or any other piece of equipment
that is used for play must be made of a material that is capable of being
disinfected and must be cleaned and disinfected promptly after the toy or other
piece of equipment has been soiled or put into the mouth of a child, or not
less than one time each day.

5. The staff of a facility shall not provide
a stuffed animal to any child unless the stuffed animal is laundered or
disinfected not less than one time each day or more often if necessary.

6. Toys placed in a crib at a facility must
be appropriate for the age of the child using the crib. The staff of a facility
shall adhere to any requirement set forth on the label of a toy regarding the
safe use of the toy.

7. Each room at a facility that is used for
play and other activities for children must have:

(a) Low, open shelves to store toys;

(b) An adequate supply of toys that are in good
condition and appropriate for the age of the children;

(c) Tables and chairs that are the appropriate size
for the children; and

(d) Any other equipment that is necessary to meet
the needs of the children.

8. Any toy that is broken or has a missing
part must be repaired or replaced before the toy may be used in the facility.

9. Walkers for children that are designed to
be moved across the floor must not be used in a facility.

(Added to NAC by Bd. for Child Care by R203-97, eff. 4-1-98;
A by R112-06, 4-23-2009)

1. Each member of the staff of a facility
that is necessary to meet the applicable requirement for the ratio of
caregivers to children set forth in NAC 432A.526
for napping or sleeping children must be on the same floor in the same building
where the children are napping or sleeping. Members of the staff of each
facility must be readily accessible and available to be summoned to ensure the
safety of the children in the facility.

2. Areas provided for napping or sleeping in
a facility must be sufficiently lighted to provide for visual supervision of
the children at all times.

3. The staff of each facility shall:

(a) Ensure that each infant under 12 months of age
is placed on his or her back on a firm mattress, mat or pad manufactured for
use by an infant when the infant is napping or sleeping;

(b) Use a safe, sturdy, well-constructed,
single-level, free-standing crib, portable crib or playpen for children to nap
or sleep in;

(c) Equip any such sleeping device with a
waterproof, firm-fitting mattress;

(d) Ensure that each crib to be used by a child who
is 6 months of age or younger is constructed with vertical slats that are not
more than 2 3/8 inches apart;

(e) Ensure that a child who is 18 months of age or
younger naps or sleeps in a crib which is appropriate for his or her age or in
another sleeping device which has been approved by the Division;

(f) Ensure that a child who is older than 18 months
of age naps or sleeps in an appropriate crib or on a cot or mat;

(g) Ensure that each sleeping device has
appropriate bedding and a waterproof and washable covering;

(h) Wipe clean each sleeping device with a
disinfectant not less than one time each week or more often if necessary;

(i) Ensure that the bedding that each child uses is
used only for that particular child;

(j) Replace the bedding each time it is wet or
soiled by a child or when the sleeping device is to be used by another child;

(k) Within 15 minutes after a child in a crib has
awakened from a nap or from sleeping, take the child out of the crib and engage
him or her in an appropriate activity;

(l) Ensure that each child takes a nap as needed;

(m) Ensure that each napping or sleeping child is
in an area from which the staff can readily hear and see the child; and

(n) Ensure that each napping or sleeping child is
checked by a caregiver not less than one time every 15 minutes.

4. The staff of a facility shall not change
the diaper of a child in a crib or other sleeping device.

5. The staff of a facility shall not use a
waterbed, sofa, soft mattress, pillow or any other soft surface as a surface on
which to place an infant under 12 months of age to nap or sleep.

NAC 432A.420Nurseries for infants and toddlers: Part of larger facility;
director. (NRS 432A.077)

1. A nursery for infants and toddlers may be
a part of another type of facility if each part of the facility meets the
requirements of this chapter. If such a nursery is a part of a larger facility,
the director or one caregiver who meets the qualifications of a director must
spend at least one-half of his or her time in the nursery.

2. In a facility where a director is not
required, the director of the nursery for infants and toddlers shall ensure
that the required number of persons on the staff is maintained.

The regulation of the Board for Child Care filed with
the Secretary of State on June 10, 1998 (LCB File No. R047-98), contains the
following provisions not included in NAC regarding the amendment of this
section by LCB File No. R203-97:

“1. A person who was approved before
April 1, 1998, as:

(a) Director of a facility for which a director
is required other than an accommodation facility or a family or group home;

(b) Director of a nursery for infants and
toddlers;

(c) Program director of a preschool; or

(d) Director of a special needs facility,

Ê is not
required to satisfy the amendatory provisions regarding the qualifications of
directors set forth in LCB File No. R203-97, which was adopted by the Board for
Child Care and was filed with the Secretary of State on April 1, 1998, so long
as the person remains at the facility in that capacity.

2. If the person wishes to become
director of a different facility or of a different program within his current
facility, he must satisfy the amendatory provisions regarding the
qualifications of directors set forth in LCB File No. R203-97, which was
adopted by the Board for Child Care and was filed with the Secretary of State
on April 1, 1998.”

NAC 432A.425Nurseries for infants and toddlers: General requirements. (NRS 432A.077)

1. The director or a designated member of
the staff of a nursery for infants and toddlers or other facility that enrolls
infants and toddlers shall discuss policies concerning the health of an infant
or toddler with the parents before enrollment of the child. Every parent must
be given a description of and agree in writing to the following matters
concerning the child:

(a) Feeding;

(b) Diapering;

(c) Changes of clothing, which are to be provided
by the parents;

(d) Bathing, including, without limitation, the
kind of soap to be used;

(e) Precautions against infectious disease;

(f) Sleeping;

(g) Toilet training;

(h) Daily reports to the parents;

(i) Any special precautions regarding the health
and safety of the child; and

(j) Any other information deemed necessary by the
facility or the Division.

2. A caregiver must be assigned to a
specific group of infants on a continuing basis.

3. Except as otherwise provided in paragraph
(n) of subsection 3 of NAC 432A.416, each infant
and toddler must be under direct visual observation by a qualified caregiver at
all times.

4. Each infant and toddler must be given
undivided attention by the same caregiver for at least 30 minutes in the
morning and 30 minutes in the afternoon, including periods of feeding and
bathing. The caregiver shall, during this time:

(a) Hold and talk to the child;

(b) Encourage the development of the child’s
coordination by allowing him or her to reach for, grasp, creep, crawl or pull
up;

(c) Give toddlers the opportunity to develop the
large muscles of the body by activities such as climbing and walking; and

(d) Encourage the child to interact socially
through playing, using language and solving problems using materials and
equipment that are appropriate for the age of the child. Infants under 6 months
of age must be provided an additional period of not less than 2 hours of
activity each day out of the crib, for example, in a playpen or other suitable
area.

5. Each licensee of a facility shall provide
an indoor area which is covered by a soft or nonabrasive material and is
protected from traveled walkways where crawling children can be on the floor
for at least a part of the day.

6. A caregiver may take the infant or
toddler assigned to him or her outside or to areas of the facility other than
their usual room for a part of each day to provide a change in their physical
environment and to increase opportunities for social interaction.

7. When weather permits, each toddler over
12 months of age must be taken outside for a portion of each day. If the
weather is extremely hot, the toddler must be kept in a shaded area while
outdoors.

8. An infant who is awake must not be left
in a crib for long periods without direct adult care and never for more than 30
minutes at a time.

9. The staff of a nursery for infants and
toddlers shall separate the infants from the toddlers while the toddlers are
engaging in physical activities.

10. There must be a resilient surface under
equipment that is used for playing and climbing at a nursery for infants and
toddlers. Such equipment must be appropriate for the age of the children using
the equipment.

11. The staff of a nursery for infants and
toddlers shall promote the healthy development of toddlers by:

(a) Expressing feelings with words;

(b) Giving directions that are worded in a positive
manner;

(c) Modeling desirable behavior; and

(d) Redirecting behavior.

12. The staff of a nursery for infants and
toddlers shall not discipline or punish an infant or toddler by confining him
or her to a crib, high chair, playpen or other such piece of furniture or
equipment.

13. The staff of a nursery for infants and
toddlers shall prepare a daily report for each infant less than 12 months of
age for whom it provides care. The report must be posted in a conspicuous place
in each room used to care for the infants and must include, without limitation,
information concerning the feeding, diapering and sleeping of each infant.

1. Each facility, including, without
limitation, a family home and a group home, shall have an early care and
education program.

2. Each facility described in subsection 1
shall develop a written assessment plan which is designed to, without
limitation:

(a) Identify the interests and needs of each child
enrolled in the facility;

(b) Describe the developmental and educational
progress of each child enrolled in the facility who is not attending public or
private elementary school;

(c) Identify the need for and referral of a child
enrolled in the facility for developmental screening and the referral of the
child for diagnostic assessment, if appropriate;

(d) Describe the methodology for developing
curriculum for the children enrolled in the facility;

(e) Adapt teaching practices and the environment to
the children enrolled in the facility;

(f) Facilitate the early care and education program
required pursuant to subsection 1; and

(g) Promote communication with the family of a
child enrolled in the facility.

3. In addition to the written assessment
plan which is developed pursuant to subsection 2, each facility described in
subsection 1 shall, within 3 months after a child enrolls in the facility,
assess the child by use of, without limitation, portfolios, observations,
checklists, rating scales and screening tools. Such an assessment must be
repeated biannually thereafter to monitor and support the learning and
development of each child enrolled in the facility.

4. Each facility described in subsection 1
shall develop a written plan of curriculum for the children enrolled in the
facility. The plan must:

(a) Be made available for parental review;

(b) Be prepared before the early care and education
program becomes effective;

(c) Be kept on file at the facility for at least 1
year;

(d) Include a program of speaking and listening to
English;

(e) Integrate age appropriate key areas of
instruction, including, without limitation, literacy, mathematics, science,
social studies, creative expression and the arts, and health and safety;

(f) Incorporate instruction, concepts and
activities that foster the social, emotional, physical, linguistic and
cognitive development of children; and

(g) Provide for the involvement of parents of the
children enrolled in the facility in learning activities at the facility and at
home.

5. Each facility described in subsection 1
shall provide materials and equipment to carry out the written plan of
curriculum developed pursuant to subsection 4 that:

(a) Reflect the lives of the children and the
families of the children enrolled in the facility;

(b) Reflect the diversity of the children in our
society with regard to the gender, age, native language, ethnicity, culture and
abilities of the children enrolled in the facility;

(c) Provide for the safety of the children enrolled
in the facility while being appropriately challenging for the children;

(d) Encourage the children enrolled in the facility
to explore, experiment and discover new information and ideas;

(e) Promote action on the part of the children
enrolled in the facility and interaction among the children enrolled in the
facility;

(f) Are organized in a manner which facilitates
independent use of the materials and equipment by a child enrolled in the
facility;

(g) Are rotated to reflect changes in the
curriculum and to accommodate the different interests and skill levels of the
children enrolled in the facility;

(h) Allow for a variety of uses; and

(i) Accommodate the special needs of the children
enrolled in the facility.

The regulation of the Board for Child Care filed with
the Secretary of State on June 10, 1998 (LCB File No. R047-98), contains the
following provisions not included in NAC regarding the amendment of this
section by LCB File No. R203-97:

“1. A person who was approved before
April 1, 1998, as:

(a) Director of a facility for which a director
is required other than an accommodation facility or a family or group home;

(b) Director of a nursery for infants and
toddlers;

(c) Program director of a preschool; or

(d) Director of a special needs facility,

Ê is not
required to satisfy the amendatory provisions regarding the qualifications of
directors set forth in LCB File No. R203-97, which was adopted by the Board for
Child Care and was filed with the Secretary of State on April 1, 1998, so long
as the person remains at the facility in that capacity.

2. If the person wishes to become
director of a different facility or of a different program within his current
facility, he must satisfy the amendatory provisions regarding the
qualifications of directors set forth in LCB File No. R203-97, which was
adopted by the Board for Child Care and was filed with the Secretary of State
on April 1, 1998.”

1. During the hours of operation, each
accommodation facility must have a person on duty who is designated as the
person responsible for the operation of the facility.

2. An accommodation facility may care for a
child for not longer than 3 1/2 hours in any 24-hour period while the adult
responsible for placing the child in the accommodation facility remains on the
premises of the business establishment which operates the accommodation
facility.

3. The accommodation facility must maintain
a daily attendance record which includes the name of each child cared for in
the facility, the child’s date of birth, the names of his or her parents or
guardians, the home address and telephone number of the parents or guardians,
the time of arrival and departure of the child and the name of a person to
contact in the case of an emergency.

4. The accommodation facility must be
located in a separate section of the business establishment and enclosed from
the other business conducted in the establishment. If the accommodation
facility is operated by a business that is licensed to sell or dispense alcohol
or to conduct gaming in any form, the accommodation facility must be physically
located in such a manner that the sale and dispensing of alcohol and the
participation in gaming ventures are isolated and obscured from the view and
hearing of the children in the accommodation facility.

5. No medication may be administered to a
child in an accommodation facility.

(a) A designated napping area for all children
cared for in the facility; and

(b) A separate area designated for infants and
toddlers.

2. Any meals or snacks provided by an
extended care accommodation facility pursuant to NAC
432A.385 may be provided by the facility or a parent of a child cared for
in the facility. Food prepared at home by a parent of a child cared for in the
facility may only be consumed by that child at the facility in accordance with
state and local health agencies.

3. In addition to the 35 square feet of
indoor space for each child required by NAC 432A.250,
an extended care accommodation facility must have:

(a) A designated indoor area that provides
sufficient space for physical activity, including, without limitation,
climbing, basketball, dancing and gymnastics; and

(b) Either a separate designated indoor area that
provides sufficient area for physical activity for infants and toddlers, or a
time in which the designated indoor area described in paragraph (a) is used
only for infants and toddlers.

4. An extended care accommodation facility
may care for a child for not longer than 5 hours in any 24-hour period.

5. An extended care accommodation facility shall
not operate as a preschool.

6. An extended care accommodation facility
shall obtain the full name, address and telephone number or pager number of at
least two persons who may be contacted by the facility in an emergency
involving the child.

7. An extended care accommodation facility
shall not provide field trips for children cared for in the facility.

(Added to NAC by Bd. for Child Care by R112-06, eff. 4-23-2009)

NAC 432A.437Facilities for special events: Licensure of applicant. (NRS 432A.077)

1. In addition to satisfying the
requirements of NAC 432A.200, an applicant for a
license to operate a facility for special events must:

(a) Have and indicate in his or her application for
a license to operate the facility for special events a permanent physical
location for the business where the records concerning the facility will be
maintained.

(b) Submit to the Division an application for a
license to operate the facility for special events for each special event for
which child care will be provided by the facility for special events, which
must include written approval from the owner or operator of the premises of the
business at which the special event will be held and at which child care will
be provided. The application must be filed with the Division at least 60
working days before the date on which the special event begins and must
include:

(2) The name of the special event and the
address at which the special event will occur;

(3) The square footage and a diagram of the
specific area in which child care will be provided;

(4) A copy of the contract which will be
provided to the parent of a child who will receive care provided by the
facility for special events;

(5) The plan for the program of care for the
children who will receive child care provided by the facility for special
events, which must be broken down by the age groups of the children who will be
served by the facility and the ages and number of children to whom child care
services will be provided; and

(6) A copy of the statement that will be
provided to each parent of a child who receives care provided by the facility
for special events which indicates that the members of the staff of the
facility may have varied levels of training and experience.

2. A license to operate a facility for
special events issued by the Division must include a statement indicating that
the members of the staff of the facility may have varied levels of training and
experience.

3. The Division shall not renew a license to
operate a facility for special events.

(Added to NAC by Bd. for Child Care by R112-06, eff. 4-23-2009)

NAC 432A.438Facilities for special events: Requirements for care of children;
records; procedures for emergencies; field trips. (NRS 432A.077)

1. Child care that is provided by a facility
for special events may be provided only:

(a) To the children of persons who are attending
the special event; and

(b) On the dates on which the special event is occurring
and may not be provided for more than:

(1) Seven days; and

(2) Ten hours in 1 day.

2. A parent of a child who is receiving
child care services from a facility for special events must provide to the
facility the full name, address and telephone number or pager number of at
least two persons who may be contacted by the facility in an emergency
involving the child.

3. A facility for special events shall
provide and accurately maintain a sheet for signing children and members of the
staff in and out of the facility.

4. A facility for special events must be
physically located in such a manner that any sale or dispensing of alcohol and
any participation in gaming ventures are obscured from the view and hearing of
the children in the facility.

5. The records of the children receiving
child care from a facility for special events must be maintained on-site at the
facility. A parent of a child receiving care from a facility for special events
must provide proper photo identification to remove the child from the facility.
The facility will allow a child to be removed from the facility by a parent of
the child only if the parent:

(a) Provides the facility with proper photo
identification; and

(b) Is preauthorized as a person who is allowed to
remove the child from the facility.

6. Any immunization records required by NRS 432A.230 for enrollment in a
facility for special events may be sent by facsimile to the facility.

7. Each facility for special events shall
ensure that a parent of a child is notified upon checking the child into the
facility of an off-site emergency location where the children receiving care at
the facility will be taken if the facility is evacuated. The emergency location
must:

(a) Be predetermined by the facility after
consultation with and approval of the security department of the business at
which the special event is being held, if any; and

(b) Not be above the main floor of the facility at
which the special event is being held.

8. Each facility for special events shall
ensure that a manager who is 21 years of age or older is on duty at the
specific area in which child care is being provided at all times that child
care is being provided by the facility.

9. Each facility for special events shall
ensure that a child who is receiving child care from the facility and who is 5
years of age or less does not participate in any field trips sponsored by the
facility unless the child is accompanied by a parent.

10. A facility for special events shall
submit to the Division a program plan for each field trip the facility plans at
least 14 days before the field trip is to occur. The plan must include, without
limitation:

(a) The company that will be providing the
transportation;

(b) An itinerary of the field trip;

(c) An estimated time of departure for and return
from the field trip;

(d) The plan for food service, which must comply
with any applicable requirements of state and local health agencies;

(e) The approximate ages and number of children who
will be participating in the field trip;

(f) Lists for the members of the staff of the
facility that identify the group of children for whom each member of the staff
will be responsible during the field trip;

(g) A system of identification that will be
prominently displayed and will assist each member of the staff in readily
identifying each child who is in the group of children for whom the member of
the staff of the facility will be responsible during the field trip;

(h) Copies of the notices of the field trip that
were sent to and authorized by a parent of each child who will be participating
in the field trip; and

(i) For each child who will be participating in the
field trip:

(1) The telephone number and names of at least
two persons who may be contacted by the facility in an emergency involving the
child; and

(2) A statement signed by a parent of the
child indicating that the child does not have any health issues that would
prevent the child from participating in the field trip.

(a) Contract with any parent for the supervision,
care and guidance of a child;

(b) Provide for the moral and religious training of
the children according to the religious belief of the child or the child’s
parents; or

(c) Accept guardianship of a child when appointed
as a guardian by a juvenile court.

2. A licensee of an institution shall:

(a) Establish the policies which it will follow and
review the policies and purposes on a regular basis to determine whether the
interests of the children are being served;

(b) Review its practices to ensure that they do not
discriminate in the employment of personnel, the admittance of children or the
services provided to children on the basis of race, color, national origin,
religion or the marital status or age of the parents;

(c) Approve a budget and be responsible for
obtaining and disbursing money;

(d) Maintain accurate records of the employment of
members of its staff;

(e) Employ a qualified person as director and
delegate to the director the responsibility for the administration of the
institution and the employment of other members of the staff; and

(f) Notify the Division of any major changes which
are pending or have occurred in the organization or administration of the
institution, including any changes in its owner or director.

3. A director of an institution shall:

(a) Possess knowledge of services available for the
welfare of children and demonstrate administrative skill and leadership;

(b) Be a graduate of an accredited college or university
and have taken a minimum of 15 credits in the social sciences;

(c) Have at least 2 years’ experience in an
administrative or supervisory position in a child care facility; and

(d) Authorize a member of the staff who is
qualified to be a director to act as director in his or her absence.

4. The director, or a person to whom he or
she has delegated responsibility, must be available to parents and the Division
at all times.

5. The licensee of an institution shall
notify the parents of a child of the child’s discharge within a reasonable time
before the discharge. Discharge of a child must be a part of a planned program
which was established after informing the child and his or her parents. Upon
discharge, the licensee of an institution shall provide pertinent information
regarding the child’s health to the person receiving the child.

6. A representative of the Division who is
authorized by the Administrator of the Division must have access to any report
of an institution which is pertinent to licensing.

7. Each licensee of an institution shall
develop a list of clothing which is required for each child at the institution
and shall maintain the child’s wardrobe at a level which is comparable to that
of other children in the community. Each child’s clothing must, by a label or
marking, be identified as belonging to the particular child. Children must, to
the greatest extent feasible, be allowed to participate in the selection and
purchase of their clothing. Donated clothing may be used at an institution only
if it is suitable for use and in good condition.

8. Any serious illness or hospitalization of
a child must be reported to the child’s parent.

9. Each licensee of an institution shall
arrange with a physician licensed in this State or with a clinic employing a
physician to serve as the medical director of or consultant to the institution
and to be responsible for a program of medical care within the institution,
which includes visits to the institution and office visits.

10. Each child must receive adequate dental
care.

11. Each licensee of an institution shall
provide:

(a) Separate toilets and bathrooms for children of
each sex who are over 6 years of age;

(b) Separate bath and toilet facilities for the
staff;

(c) One toilet for every eight children, one tub or
shower for every eight children and one washbasin for every four children; and

(d) At least one toilet and washbasin near every
living room and recreation area.

12. A licensee of an institution shall:

(a) Provide each child with a bed for the child’s
own use, which must be at least 30 inches wide, of a length which is adequate
for the child’s height and the bottom of which is at least 6 inches above the
floor;

(b) Provide separate sleeping areas for boys and
girls;

(c) House no more than four children in one
sleeping area, except that partitions may be used in large areas;

(d) Keep all beds at least 3 feet apart at the
head, foot and sides;

(e) Provide each bed with level box springs, a
comfortable and supportive mattress in good condition, a pillow, two sheets and
coverings which are sufficient for the child’s comfort;

(f) Provide a complete change of clean bed linens
at least once a week; and

(g) Provide each child with a closet, locker or
dresser for clothing and personal belongings, access to which must be reserved
solely to the child.

1. A licensee of a child care institution
shall maintain a ratio of social workers to children that will fulfill the
needs of the children, but there must be at least two social workers for every
50 children in the institution.

2. Each social worker must:

(a) Possess a bachelor’s or more advanced degree
which is based on at least 15 credits in the social sciences; and

(b) Within 2 years after commencing employment with
the institution, participate in at least 180 hours of documented training while
in service.

(Added to NAC by Bd. for Child Care, eff. 8-31-84)—(Substituted
in revision for NAC 432A.295)

(2) The procedure for admission and the
information which must be contained in an application for admission.

(b) Obtain or develop a complete social study of
each child not later than 30 days after his or her admission.

(c) If caring for a child for money, enter into a
written agreement with the parent of the child which outlines the duties and
responsibilities of each party.

2. Each licensee of an institution shall:

(a) Establish a regular program of activities which
has sufficient flexibility to respond to the needs of each child;

(b) Integrate the institutional programs with
activities in the community in a manner that allows children to participate in
the normal living patterns of the community;

(c) Maintain and develop constructive relationships
between the child and his or her parents, brothers and sisters, other relatives
and members of the staff of the institution;

(d) Make the greatest use of small groups of
persons to aid in developing the individuality of the child and helping him or
her to attain a sense of personal identity;

(e) Establish a program of personal hygiene for
every child;

(f) Provide every child with his or her own
toiletries, including a toothbrush and comb, and with clean towels and
washcloths;

(g) Provide space for individual storage of
toiletries; and

(h) Establish policies governing the social,
emotional, physical and intellectual development of each child.

3. Each licensee of an institution shall
provide supervised work for each child which is appropriate to the age, health
and abilities of the child. Work must be assigned for the purpose of training
and contributing to the growth of the particular child. Work must not interfere
with the child’s time for school, periods of study, play and sleep, normal
relations within the community or visits with his or her family.

4. A licensee of an institution shall
establish a written policy which sets forth:

(a) Any daily chores that a child is expected to
perform; and

(b) Any merit system that will be used by the
institution to provide consequences to a child for his or her conduct.

5. A licensee of an institution shall not
use any child to solicit money for the institution in any way which would be
harmful or cause embarrassment to the child or his or her family. The written
consent of the parent or legal guardian must be obtained before an institution
may use a child’s picture or name in any written, visual or oral system of
communication.

6. Each licensee of an institution shall
have written policies on religious training. The consent of a child’s parent
must be obtained before a child may attend church or receive religious
instruction.

7. Each licensee of an institution is
responsible for providing academic or vocational training to each child. The
licensee of an institution shall, by using resources in the community, provide
specialized training for children who are unable to benefit from a regular
school program because of their physical, mental or emotional disabilities.

8. Recreation and programs of activity must
be planned as an integral part of the institution’s total program.

9. Each licensee of an institution shall
have a written, planned program to supervise the children’s health and provide
medical and dental care.

10. Each licensee of an institution shall
provide a statement outlining the policies and procedures concerning the use of
isolation or restraints on the children in the institution. The members of the
staff of the institution must be trained and certified through a nationally
recognized organization concerning the use of restraints. If isolation or
restraints are used, a committee established by the institution must evaluate
and review the process concerning the use of isolation or restraints within 30
days after isolation or restraints are used to determine:

(a) Whether safety guidelines were followed by the
institution;

(b) The effectiveness of the process concerning
modifying the behavior of the child; and

(c) The institution’s compliance with the written
policies and procedures of the institution.

1. Each licensee of an institution shall
maintain an individual record for each child accepted for care. The record is
confidential and must be protected from examination by unauthorized persons.

2. Every record must contain the following
information, if available:

(a) The child’s full name, birthplace and date of
birth;

(b) The religion of the child and his or her
parents;

(c) Both parents’ full names;

(d) If the child’s parents are deceased, the date,
place and cause of death;

(e) If the child’s parents are divorced or
separated, the date and place of the divorce or separation;

(f) The names, addresses and dates of birth of
other children in the family;

(g) The names and addresses of close relatives;

(h) The name of a person to whom the child may be
referred for care;

(i) The date and reason for placement of the child;

(j) The financial terms of the placement;

(k) The report of the original study and
investigation of the child, including:

(1) All information concerning the educational,
economic and cultural background of the child’s family; and

(2) All personal information about the child,
including his or her:

(I) History of development and health;

(II) Personality;

(III) Placement and adjustment in school;

(IV) Previous placements in institutions;
and

(V) Relationships with his or her family;

(l) Any available documents pertaining to the
current legal custody of the child;

(m) Every written contract between the licensee of
an institution and the child’s parents, except an authorization to provide
medical care, which must be kept in the records of the health of the child;

(n) Reports and records of schools attended by the
child, including his or her grades, progress and adjustment;

(o) Records or summarized reports of the child’s
progress and development while under care, the work done with the child’s
family, and plans for care and supervision of the child after discharge;

(p) If members of the staff of another agency or
institution are also working with the child, the licensee of an institution
mainly providing care to the child shall periodically provide the staff members
of the other agency or institution with summary reports of the services it is
providing and shall formulate plans for continuing the services, for
maintaining an appropriate staff and for arranging conferences with other
agencies and institutions who are also providing care for the child; and

(q) Reports of the staff of the institution
concerning the child’s adjustment to the institutional setting.

NAC 432A.470Special needs facilities: Meeting required before admission of
child. (NRS 432A.077)Before a
child may be admitted to a special needs facility, the child’s parents, the
appropriate members of the staff of the facility and any appropriate
specialists shall meet to determine whether the needs of the child can be
adequately met by the facility and to ascertain the information and training
which must be obtained from the child’s parents and other persons who provide
services to the child.

(Added to NAC by Bd. for Child Care, eff. 5-14-90)

NAC 432A.475Special needs facilities: Training of staff; plan of services. (NRS 432A.077)A
special needs facility shall provide the members of its staff with appropriate
training and prepare a written plan of services for each child with special
needs it accepts. The plan of services must contain:

1. The name, age and date of birth of the
child;

2. The name, address and telephone number of
the parents of the child;

3. Any information needed to contact the
parents of the child;

4. Any information needed to contact an
appropriate person in an emergency;

5. The name and telephone number of any
physician or specialist who is treating the child;

6. The name and telephone number of any
special consultants who are available to the facility to assist in the care or
treatment of the child;

7. The signatures of all persons
participating in and agreeing to abide by the plan;

8. If relevant to the plan, a diagnosis of
the child’s special condition;

9. Any special needs of the child,
precautions or arrangements concerning:

(a) Diet and feeding;

(b) Devices and equipment;

(c) Positioning;

(d) Body wastes;

(e) Communication;

(f) Management of behavior; and

(g) Modification of the building or other aspects
of the environment;

10. Any specific plans for training the
members of the staff of the facility regarding any needs, precautions or
arrangements identified pursuant to subsection 9; and

11. A date for review of the plan by the
parents of the child, the appropriate members of the staff of the facility, and
the physician of the child, if appropriate.

1. Have earned a bachelor’s or associate’s
degree, and have completed at least:

(a) Twelve semester hours of education, of which:

(1) Three semester hours are in child
development;

(2) Six semester hours are in the education of
children with special needs; and

(3) Three semester hours are in child
psychology, education related to the health of children, the education of
children with special needs or courses directly related to those subjects; and

(b) Six months of verifiable experience,
satisfactory to the Division, in a program related to the education of
children, early childhood development, child care or the education of children
with special needs;

2. Have earned a high school diploma or a
certificate based on general educational development approved by the
Administrator of the Division, and have completed at least:

(a) Twelve semester hours of education, of which:

(1) Three semester hours are in child
development;

(2) Six semester hours are in the education of
children with special needs; and

(3) Three semester hours are in child
development, child psychology, education related to the health of children, the
education of children with special needs or courses directly related to those
subjects; and

(b) Two years of verifiable experience satisfactory
to the Division, in a program related to child education, early childhood
development, child care or the education of children with special needs; or

3. Have a combination of education and
experience which, in the judgment of the Administrator of the Division, is
equivalent to the requirements of subsection 1 or 2.

(Added to NAC by Bd. for Child Care, eff. 5-14-90; A by
R203-97, 4-1-98)

REVISER’S NOTE.

The regulation of the Board for Child Care filed with
the Secretary of State on June 10, 1998 (LCB File No. R047-98), contains the
following provisions not included in NAC regarding the amendment of this
section by LCB File No. R203-97:

“1. A person who was approved before
April 1, 1998, as:

(a) Director of a facility for which a director
is required other than an accommodation facility or a family or group home;

(b) Director of a nursery for infants and
toddlers;

(c) Program director of a preschool; or

(d) Director of a special needs facility,

Ê is not
required to satisfy the amendatory provisions regarding the qualifications of
directors set forth in LCB File No. R203-97, which was adopted by the Board for
Child Care and was filed with the Secretary of State on April 1, 1998, so long
as the person remains at the facility in that capacity.

2. If the person wishes to become
director of a different facility or of a different program within his current
facility, he must satisfy the amendatory provisions regarding the
qualifications of directors set forth in LCB File No. R203-97, which was
adopted by the Board for Child Care and was filed with the Secretary of State
on April 1, 1998.”

1. The State Board of Health hereby declares
infection with streptococcus pneumoniae to be a communicable disease.

2. Unless excused because of religious
belief or medical condition, a child may not be enrolled in a child care
facility in this State unless he or she has been immunized against
streptococcus pneumoniae.

1. The State Board of Health hereby declares
infection with Haemophilus influenzae type b to be a communicable disease.

2. Unless excused because of religious belief
or medical condition, a child may not be enrolled in a child care facility in
this State unless he or she has been immunized against Haemophilus influenzae
type b.

1. If the operator of a facility
conditionally admits a child whose parent has not established permanent
residence in the county in which the facility is located, the operator shall
keep the proof submitted by the parent that he or she has not established a
permanent residence in the county on file at the facility for 1 year. The proof
must be in the form designated by the licensing authority and may include a
driver’s license.

2. In any case governed by this section, the
parent shall submit a written statement of the immunization status of the child
to the operator of the facility. The statement must be signed by the parent.

1. A licensee of a child care facility shall
have a staff which is sufficient in number to provide physical care,
supervision and individual attention to each child and allow time for
interaction between the staff and the children to promote the children’s social
competence, emotional well-being and intellectual development.

2. Except as otherwise provided in
subsection 3, in addition to the number of caregivers that are required to
satisfy the applicable ratio of caregivers to children set forth in NAC 432A.524, one additional caregiver or an adult
volunteer per each group of children must be present on all field trips away
from the child care facility to assist in providing direct supervision to the
children and to increase the safety of the children.

3. The provisions of subsection 2 do not
apply:

(a) If the purpose for leaving the child care
facility is to transport the children from the child care facility to another
location and, upon reaching that location, the responsibility for caring for
the children is assumed by another adult.

(b) To a group of children that is composed
entirely of children of school age, including children who are attending
kindergarten.

4. A member of the staff of a facility who
is supervising a child pursuant to subsection 1 must:

(a) Be physically present in the room where the
child being supervised is present;

(b) Observe, oversee and guide the child;

(c) Be aware of the needs of the child and
accountable for the care of the child; and

(d) Maintain a proximity to the child that allows
the member of the staff to be capable of intervening if assistance or direction
is needed by the child.

1. A licensee of a nursery for infants and
toddlers shall have on duty at least the following number of caregivers:

(a) If all children in the nursery are under 9
months old, one caregiver for every four children;

(b) If all children in the nursery are between 9
months and 18 months old, one caregiver for every six children; or

(c) If all children in the nursery are between 18
months and 3 years old, one caregiver for every eight children,

Ê except that
if there are more than six children in the facility, there must be at least two
caregivers on duty in the facility.

2. If the nursery contains children from
more than one of these age groups, the required number of staff members is
determined by computing the average of the ages of all children attending the
nursery and using the average age to determine the applicable ratio of
caregivers to children.

(Added to NAC by Bd. for Child Care, eff. 8-31-84; A 1-29-85;
R112-06, 4-23-2009)—(Substituted in revision for NAC 432A.331)

NAC 432A.524Child care centers and accommodation facilities: Caregivers
during the day. (NRS 432A.077)Except
as otherwise provided in NAC 432A.290, 432A.532 and 432A.546, a
licensee of a child care center or accommodation facility shall have on duty
between the hours of 6:30 a.m. and 9:00 p.m. at least the following number of
caregivers:

1. Where the children are 2 years of age and
older:

(a) For 1 to 6 children, inclusive, one caregiver;

(b) For 7 to 20 children, inclusive, two
caregivers;

(c) For 21 to 35 children, inclusive, three caregivers;

(d) For 36 to 50 children, inclusive, four
caregivers;

(e) For 51 to 65 children, inclusive, five
caregivers;

(f) For 66 to 80 children, inclusive, six
caregivers;

(g) For 81 to 93 children, inclusive, seven
caregivers; and

(h) For every 13 children in excess of 93, one
additional caregiver.

2. In a classroom which contains children
who are 2 or more years of age but less than 3 years of age:

(a) For 1 to 10 children, inclusive, one caregiver;

(b) For 11 to 20 children, inclusive, two caregivers;

(c) For 21 to 30 children, inclusive, three
caregivers; and

(d) For every 1 to 10 children, inclusive, in
excess of 30, one additional caregiver.

1. Except as otherwise provided in NAC 432A.532 and 432A.546,
a licensee of a child care center, accommodation facility or facility for
special events which is operated between the hours of 9:00 p.m. and 6:30 a.m.
shall have on duty the following number of caregivers:

(a) For 1 to 15 children, inclusive, one caregiver;

(b) For 16 to 31 children, inclusive, two
caregivers;

(c) For 32 to 46 children, inclusive, three
caregivers;

(d) For 47 to 61 children, inclusive, four
caregivers; and

(e) For every 15 children in excess of 61, one
additional caregiver.

2. Every member of the staff of a child care
center, accommodation facility or facility for special events who is on duty at
night shall remain awake during duty hours.

1. Whenever one or more infants or toddlers
who are under 2 years of age are being cared for in a child care center, the
licensee shall have at least one caregiver on duty who is designated to provide
that care.

2. An additional caregiver must be on duty
whenever more than six infants or toddlers who are under 30 months of age are
in a child care center between the hours of 6:30 a.m. and 9:00 p.m.

(Added to NAC by Bd. for Child Care, eff. 8-31-84; A by
R112-06, 4-23-2009)—(Substituted in revision for NAC 432A.334)

1. A licensee of a child care center may, after
obtaining the written permission of the Administrator of the Division, provide
care before and after normal school hours for up to three additional children
or 10 percent more children than the number stated on the facility’s license,
whichever number is greater, if each of the additional children is attending
first grade or a grade higher than first grade but is less than 16 years of
age.

2. A licensee of a child care center who
accepts such additional children shall have one additional caregiver for up to
20 children so accepted and one additional caregiver for every 1 to 20
additional children thereafter.

3. The care must not exceed 3 consecutive
hours before normal school hours and 3 consecutive hours after normal school
hours.

(Added to NAC by Bd. for Child Care, eff. 8-31-84; A by
R112-06, 4-23-2009)—(Substituted in revision for NAC 432A.338)

NAC 432A.532Special needs facilities. (NRS
432A.077)Except
as otherwise provided in NAC 432A.546, a licensee
of a special needs facility in which care is provided to children who are 2
years of age and older shall have on duty at all times at least the following
number of caregivers:

1. For 1 to 6 children, inclusive, one
caregiver;

2. For 7 to 20 children, inclusive, two
caregivers;

3. For 21 to 30 children, inclusive, three
caregivers;

4. For 31 to 40 children, inclusive, four
caregivers;

5. For 41 to 50 children, inclusive, five
caregivers;

6. For 51 to 60 children, inclusive, six
caregivers;

7. For 61 to 70 children, inclusive, seven
caregivers;

8. For 71 to 80 children, inclusive, eight
caregivers;

9. For 81 to 90 children, inclusive, nine
caregivers;

10. For 91 to 100 children, inclusive, 10
caregivers; and

11. For every 6 children in excess of 100,
one additional caregiver.

(Added to NAC by Bd. for Child Care, eff. 5-14-90; A by
R112-06, 4-23-2009)—(Substituted in revision for NAC 432A.480)

(a) Not more than four of the children may be less
than 2 years of age, and not more than two of the children may be less than 1
year of age; and

(b) Any children of the person who is required to
reside in the facility pursuant to subsection 3 who are less than 3 years of
age will be counted for the purpose of the ratios set forth in this section.

2. Except as otherwise provided in NAC 432A.546, a licensee of a family home shall:

(a) Have one caregiver on duty at all times;

(b) Have a second caregiver on duty whenever four
or more of the children in the facility are children with special needs; and

(c) Provide an alternate caregiver in case of an
emergency.

3. If a licensee of a family home is:

(a) A natural person, the licensee shall:

(1) Reside in the facility; and

(2) Provide direct care to the children in the
facility.

(b) Not a natural person, one of the persons listed
on the license pursuant to NRS
432A.150 as a person authorized to operate the facility shall:

The regulation of the Board for Child Care filed with
the Secretary of State on April 23, 2009 (LCB File No. R112-06), which amended
this section, contains the following provision not included in NAC:

“Sec. 83. 1. Each
person who, on the effective date of this section [April 23, 2009], is required
to reside in a family home pursuant to subsection 3 of NAC
432A.534 or is required to reside in a group home pursuant to subsection 3
of NAC 432A.536 shall, on or before December 31,
2011, apply with The Nevada Registry or its successor organization.

(c) “The Nevada Registry” has the meaning
ascribed to it in section 7 of this regulation [NAC
432A.143].

Sec. 84. 1. Notwithstanding
the provisions of NAC 432A.534, a person who, on
the effective date of this section [April 23, 2009], is a licensee of a family
home is not required to satisfy the amendatory requirements of paragraph (b) of
subsection 1 of NAC 432A.534 until January 1,
2012.

2. As used in this section, “family home”
has the meaning ascribed to it in NAC 432A.100.”

1. In a group home, not more than eight of
the children may be less than 3 years of age, and not more than four of the
children may be less than 1 year of age.

2. Except as otherwise provided in NAC 432A.546, a group home must have one caregiver on
duty at all times. An additional caregiver must be on duty whenever one or more
of the following conditions exist:

(a) More than six children are in the facility;

(b) More than four of the children are less than 2
years of age; or

(c) More than two of the children are less than 1
year of age.

Ê Three
caregivers must be on duty whenever eight or more of the children in the
facility are children with special needs.

3. If a licensee of a group home is:

(a) A natural person, the licensee shall:

(1) Reside in the facility; and

(2) Provide direct care to the children in the
facility.

(b) Not a natural person, one of the persons listed
on the license pursuant to NRS
432A.150 as a person authorized to operate the facility shall:

The regulation of the Board for Child Care filed with
the Secretary of State on April 23, 2009 (LCB File No. R112-06), which amended
this section, contains the following provision not included in NAC:

“1. Each person who, on the effective
date of this section [April 23, 2009], is required to reside in a family home
pursuant to subsection 3 of NAC 432A.534 or is
required to reside in a group home pursuant to subsection 3 of NAC 432A.536 shall, on or before December 31, 2011,
apply with The Nevada Registry or its successor organization.

1. A licensee of a family home or group home
may, after obtaining the written permission of the Administrator of the
Division, provide care before and after normal school hours for as many as
three children in addition to the number stated on the facility’s license if
each of the additional children is:

(a) At least 6 years of age or is attending school
for a full day; and

(b) Less than 16 years of age.

2. Children who live in such a home and are
11 years of age or less must be included in counting the additional children.

3. The care must not exceed 3 consecutive
hours before normal school hours and 3 consecutive hours after normal school
hours.

(Added to NAC by Bd. for Child Care, eff. 8-31-84; A by
R112-06, 4-23-2009)—(Substituted in revision for NAC 432A.337)

1. A licensee of a facility that provides
care for ill children shall have on duty at least the following number of
staff:

(a) If all children in the facility are younger
than 2 years old, one member of the staff for every three children;

(b) If all children in the facility are between 2
years and 3 years old, one member of the staff for every four children;

(c) If all children in the facility are between 3
years and 6 years old, one member of the staff for every five children; or

(d) If all children in the facility are older than
6 years, one member of the staff for every seven children.

2. If the director provides care for ill
children, he or she may be included in calculating the ratio of staff to
children.

3. If a facility that provides care for ill
children contains children from more than one of these age groups, the required
number of staff is determined by computing the average of the ages of all
children attending the facility and using the average age to determine the
applicable ratio of staff to children.

(Added to NAC by Bd. for Child Care, eff. 3-11-92)

NAC 432A.541Child care institutions. (NRS 432A.077)Except
as otherwise provided in NAC 432A.546, a licensee
of a child care institution shall have on duty between the hours of 6:30 a.m.
and 9:00 p.m. at least the following number of caregivers if the children are 2
years of age or older:

1. For 1 to 6 children, inclusive, one
caregiver;

2. For 7 to 20 children, inclusive, two
caregivers;

3. For 21 to 35 children, inclusive, three
caregivers;

4. For 36 to 50 children, inclusive, four
caregivers;

5. For 51 to 65 children, inclusive, five
caregivers;

6. For 66 to 80 children, inclusive, six
caregivers;

7. For 81 to 93 children, inclusive, seven
caregivers; and

8. If the number of children is greater than
93:

(a) At a residential child care institution, for
every 10 children in excess of 93, one additional caregiver;

(b) At a shelter child care institution, for every
13 children in excess of 93, one additional caregiver; and

(c) At an educational child care institution, for
every 18 children in excess of 93, one additional caregiver.

1. Except as otherwise provided in NAC 432A.546, a licensee of an educational child care
institution shall have on duty between the hours of 9:00 p.m. and 6:30 a.m.,
when children are generally asleep, at least the following number of
caregivers:

(a) For 1 to 25 children, inclusive, one caregiver;
and

(b) For every 25 children in excess of 25, one
additional caregiver plus an additional on-call or back-up person on-site.

2. Every member of the staff who is on duty
at night shall remain awake during duty hours.

1. Except as otherwise provided in NAC 432A.546, a licensee of a residential child care
institution shall have on duty between the hours of 9:00 p.m. and 6:30 a.m.,
when children are generally asleep, at least the following number of
caregivers:

(a) For 1 to 15 children, inclusive, one caregiver;

(b) For 16 to 31 children, inclusive, two
caregivers;

(c) For 32 to 46 children, inclusive, three
caregivers;

(d) For 47 to 61 children, inclusive, four
caregivers; and

(e) For every 15 children in excess of 61, one
additional caregiver.

2. Every member of the staff who is on duty
at night shall remain awake during duty hours.

1. Except as otherwise provided in NAC 432A.546, a licensee of a shelter child care
institution shall have on duty between the hours of 9:00 p.m. and 6:30 a.m.,
when children are generally asleep, at least the following number of
caregivers:

(a) For 1 to 15 children, inclusive, one caregiver;

(b) For 16 to 31 children, inclusive, two
caregivers;

(c) For 32 to 46 children, inclusive, three
caregivers;

(d) For 47 to 61 children, inclusive, four
caregivers; and

(e) For every 15 children in excess of 61, one
additional caregiver.

2. Every member of the staff who is on duty
at night shall remain awake during duty hours.

1. Portable wading pools and other
containers of water may be used in a facility if:

(a) The depth of the water in the pool or container
does not exceed 6 inches; and

(b) The pool or container is emptied, cleaned and
sanitized immediately after each use.

2. A facility which provides activities in
water that has a depth greater than 6 inches, other than a swimming lesson
which is taught at a public swimming pool, shall ensure that:

(a) No child is in water with a depth that is higher
than the chest of the child while the child is standing;

(b) At least one caregiver is within arm’s reach of
each child who is less than 3 years of age;

(c) The children are not allowed to wade or swim in
a moving body of water, including, without limitation, a stream, river, creek
or irrigation ditch; and

(d) At least one person who is currently certified
as a lifeguard or water safety instructor by the American National Red Cross or
an equivalent water safety program is supervising the children. A public
lifeguard may satisfy the requirement of this paragraph.

3. A facility which offers an activity in
the water as described in subsection 2 must offer the activity as an optional
activity.

4. When children cared for in a facility are
engaged in an activity in the water as described in subsection 2 and the
children are:

(a) Less than 3 years of age, the ratio of
caregivers to children must be one caregiver for each child;

(b) At least 3 years of age but less than 6 years
of age, the ratio of caregivers to children must be one caregiver for every 4
children; and

(c) Except as otherwise provided in subsection 5,
at least 6 years of age or older, the ratio of caregivers to children must be
one caregiver for every 6 children.

5. When children cared for in a facility are
engaged in an activity in the water as described in subsection 2 and the
children are at least 6 years of age or older, if:

(a) There are more than 6 children but less than 12
children engaged in the activity, the ratio of caregivers to children must be
two caregivers for each group of that size;

(b) There are at least 12 children but less than 20
children engaged in the activity, the ratio of caregivers to children must be
three caregivers for each group of that size; and

(c) There are 20 or more children engaged in the
activity, the ratio of caregivers to children must be three caregivers plus one
additional caregiver for every sixth additional child in excess of 20 children.

(b) The recognition of signs and symptoms of
childhood illnesses and the care of childhood illnesses.

3. The director must be:

(a) At least 21 years of age; and

(b) Certified in the administration of
cardiopulmonary resuscitation.

4. The certification in the administration
of cardiopulmonary resuscitation set forth in subsection 3 must be obtained
before a person may hold the position of director of a facility that provides
care for ill children.

(Added to NAC by Bd. for Child Care, eff. 3-11-92; A by
R203-03, 7-1-2004)

REVISER’S NOTE.

The regulation of the Board for Child Care filed with
the Secretary of State on July 1, 2004 (LCB File No. R203-03), which amended
this section, contains the following provisions not included in NAC:

“1. Notwithstanding the amendatory
provisions of NAC 432A.560 and subsection 2 of NAC 432A.570, each person who, on July 1, 2004, is a
director of a facility that provides care for ill children or a member of the
staff of such a facility shall obtain the certification in the administration
of cardiopulmonary resuscitation required pursuant to the provisions of section
3 of this regulation [NAC 432A.322] within 12
months after July 1, 2004, unless on July 1, 2004, the person is certified in
the administration of cardiopulmonary resuscitation and that certification
satisfies the requirements set forth in section 3 of this regulation [NAC 432A.322].

2. Evidence that the director of the
facility or the member of the staff of the facility has completed the
requirements of subsection 1 must be included in his personnel file and must be
kept at the facility.”

NAC 432A.565Director of facility: General duties. (NRS 432A.077)The
director of a facility that provides care for ill children shall:

1. Provide a child with activities during
the day that meet the needs of the child, including:

(a) Activities that take place inside or outside
and which are consistent with the developmental level, ability and physical
condition of the child and the plan of care for the child;

1. Each member of the staff of a facility
that provides care for ill children:

(a) Must be at least 18 years of age.

(b) Must be trained and certified in first aid and
in the administration of cardiopulmonary resuscitation.

(c) Shall earn a total of 3 hours of training each
year in the control of communicable diseases and the recognition and treatment
of childhood illnesses.

(d) Must provide to the facility his or her record
of immunizations before beginning employment.

2. The certification in the administration
of cardiopulmonary resuscitation set forth in subsection 1 must be obtained
before a person may be employed as a member of the staff of a facility that
provides care for ill children.

3. Evidence that a member of the staff has
completed the requirements of paragraphs (b), (c) and (d) of subsection 1 must
be included in his or her personnel file and must be kept at the facility.

(Added to NAC by Bd. for Child Care, eff. 3-11-92; A by
R203-03, 7-1-2004)

REVISER’S NOTE.

The regulation of the Board for Child Care filed with
the Secretary of State on July 1, 2004 (LCB File No. R203-03), which amended
this section, contains the following provisions not included in NAC:

“1. Notwithstanding the amendatory
provisions of NAC 432A.560 and subsection 2 of NAC 432A.570, each person who, on July 1, 2004, is a
director of a facility that provides care for ill children or a member of the
staff of such a facility shall obtain the certification in the administration
of cardiopulmonary resuscitation required pursuant to the provisions of section
3 of this regulation [NAC 432A.322] within 12
months after July 1, 2004, unless on July 1, 2004, the person is certified in
the administration of cardiopulmonary resuscitation and that certification
satisfies the requirements set forth in section 3 of this regulation [NAC 432A.322].

2. Evidence that the director of the
facility or the member of the staff of the facility has completed the
requirements of subsection 1 must be included in his personnel file and must be
kept at the facility.”

1. The licensee of a facility that provides
care for ill children shall develop and carry into effect written standards for
the operation of the facility.

2. The standards must include:

(a) An admission policy;

(b) Procedures for the control of infection;

(c) Methods for the daily care of children;

(d) Procedures for recording information about a
child;

(e) Plans for the training of staff;

(f) Procedures for the care and referral of a child
with worsening symptoms;

(g) Procedures for communication by staff to
parents and health care providers;

(h) Procedures for feeding and bathing a child;

(i) Procedures for a daily examination of each
child in accordance with NAC 432A.595;

(j) Procedures for providing emergency health care,
including community resources and referrals;

(k) Procedures for the use and administration of
medication in accordance with NAC 432A.585;

(l) Procedures for cleaning the facility;

(m) Procedures for administering first aid;

(n) Procedures for storage of sanitizing materials;

(o) A requirement that each room in which an ill
child resides must have a sink for washing hands that is equipped with soap and
paper towels; and

(p) A requirement that separate areas must be
provided for changing the diapers of children who are ill and children who are
well.

(Added to NAC by Bd. for Child Care, eff. 3-11-92; A by
R112-06, 4-23-2009)

NAC 432A.585Procedures for use and administration of medication. (NRS 432A.077)Procedures
for the use and administration of medication in a facility that provides care
for ill children must include the following provisions:

1. Except as otherwise provided in this
subsection, only the director or a person designated by the director may
administer medication to a child or provide assistance to a child who
administers medication to himself or herself.

2. All prescription medications must be:

(a) Authorized by a physician;

(b) In the original container which must have a
child-proof lid;

(c) Labeled with the name of the child, the date
and directions for administration; and

(b) Labeled with the name of the child, the date
and directions for administration;

(c) Refrigerated, if required; and

(d) Kept in a container which has a child-proof
lid.

4. Except as otherwise provided in
subsection 10, the director may administer medication to a child after
receiving an oral order from a physician if the director requests a written
confirmation of the order from the physician.

5. Except as otherwise provided in
subsection 6, all medications must be locked and inaccessible to children.

6. Medications that require refrigeration
must be kept separate from food and inaccessible to children.

7. Unused medication must be returned to a
parent and outdated medicine must be discarded.

8. The director shall post a chart in a
conspicuous place that includes:

(a) Information on the health and medication of the
children in the facility; and

(b) A record of the administration of medication of
each child.

9. A member of the staff shall note in the
record of a child and the director shall advise a parent of:

(a) All medication administered to a child; and

(b) The occurrence of any health problem, including
diarrhea, vomiting, continuous hunger, refusal to eat, a nosebleed, a skin rash
or high temperature.

10. Only persons trained in the
administration of medication by a health care professional or a parent of a
child cared for in a facility and authorized pursuant to NRS 453.375 or 454.213 may administer medication
to the child.

(Added to NAC by Bd. for Child Care, eff. 3-11-92; A by
R112-06, 4-23-2009)

1. The director may admit a child to a
facility that provides care for ill children only if a parent brings the child
to the facility and releases the child to a member of the staff.

2. An initial evaluation of each child must
be conducted upon the child’s arrival by the director or a physician, a
physician assistant, an advanced practice registered nurse, a registered nurse
or a licensed practical nurse who has the qualifications required by subsection
1 of NAC 432A.560.

3. The initial evaluation must include:

(a) An assessment of the child’s condition and the
name of the person making the assessment;

(b) The status of the child’s illness, including
contagion and duration;

(c) A recommendation for the number of evaluations
of the child to be conducted by a member of the staff during the day; and

(d) Recommendations for the diet and activity level
of the child.

(Added to NAC by Bd. for Child Care, eff. 3-11-92)

NAC 432A.600Admission of child: Medical conditions requiring approval of
appropriate health authority. (NRS
432A.077)The
director of a facility that provides care for ill children shall not admit a
child who has one or more of the following conditions unless the admittance is
approved by the appropriate health authority:

1. Diarrhea:

(a) That is caused by shigella, salmonella,
campylobacter or giardia;

(b) That is accompanied by dehydration or loss of
fluid;

(c) That is accompanied by blood, mucus or loss of
color in the stools;

(d) That is accompanied by poor fluid intake;

(e) That is accompanied by marked lethargy; or

(f) For more than 3 days, unless the parent
provides evidence that the child is under the care of a physician.

2. Difficulty breathing or rapid breathing.

3. Asthma and a severe upper respiratory
infection, unless the parent provides evidence that the child is under the care
of a physician.

1. A member of the staff of the facility
that provides care for ill children shall conduct evaluations of each child as
recommended by the director or health care provider who performed the initial
evaluation of the child.

2. After each evaluation the member of the
staff shall record:

(a) The date and time of each evaluation;

(b) The temperature, pulse and respiration of the
child;

(c) The amount of food and fluid ingested by the
child;

(d) The color, consistency and number of the
child’s stools; and

(e) A description of the activity of the child,
including sleep, rest and play.

1. The director of a facility that provides
care for ill children shall:

(a) Immediately notify a parent of any significant
change in his or her child’s illness or any injury received in the facility
more serious than a minor cut or scratch; and

(b) Obtain instructions from the parent for a
course of action.

2. If the director determines that a child’s
illness or injury exceeds the maximum level of care for which the facility is
licensed, the parent must be notified and the child must be removed from the
facility. If the parent cannot be contacted, the director shall follow the
provisions for emergency care on the medical release form.

1. Each outdoor youth program must have a
governing body that has authority over the policies and activities of the
program.

2. The governing body must be:

(a) The board of directors, if the provider is a
nonprofit organization;

(b) The board of directors, if the provider is an
organization that operates for a profit; or

(c) The owner, if the provider is a natural person.

3. The governing body shall:

(a) Establish the policy of the outdoor youth
program;

(b) Ensure compliance with the policy of the
outdoor youth program;

(c) Ensure compliance with the requirements of
federal, state and local statutes, regulations and ordinances;

(d) Notify the Division within 30 days after a
change in the administration of the program or the purpose of the program;

(e) Ensure that the program is adequately funded
and financially sound;

(f) Maintain a list of the members of the governing
body, including the name, address and term of each member; and

(g) Prepare a chart of the program’s organization
and a summary that identifies and describes all units of operation within the
program. The chart and summary must define the lines of authority and the
responsibility of each member of the staff.

4. If the governing body is composed of more
than one person, the governing body shall:

1. At all times, maintain records of
enrollment for all clients at the base camp;

2. For at least 3 years, maintain complete
and accurate accounts, books and records in a manner that is accessible and
standardized; and

3. Provide information that is accurate and
factual to the parents of the clients, the community and the media.

(Added to NAC by Bd. for Child Care, eff. 3-11-92)

NAC 432A.650Proof of solvency of program. (NRS
432A.077)A
provider shall not conduct an outdoor youth program unless it maintains at
least $100,000 in an account that is established for the purpose of proving the
solvency of the program.

(Added to NAC by Bd. for Child Care, eff. 3-11-92)

NAC 432A.655Plan to ensure quality of program; records of use of plan. (NRS 432A.077)

1. A provider shall prepare a plan to ensure
the quality of the program. The plan must describe the methods and standards
used by the provider to ensure that his or her services are of a high quality.

2. The provider shall maintain records of
his or her use of the plan.

3. The provider shall make the plan and the
records of its use available for review at the base camp.

(Added to NAC by Bd. for Child Care, eff. 3-11-92)

NAC 432A.660Guidelines and procedures for administration of program. (NRS 432A.077)A
provider shall prepare guidelines and procedures for administration to ensure
that the outdoor youth program is managed properly.

(Added to NAC by Bd. for Child Care, eff. 3-11-92)

NAC 432A.665Appointment of field administrator. (NRS
432A.077, 432A.380)The
provider shall appoint a field administrator who meets the qualifications set
forth in NRS 432A.380.

1. The field administrator shall adopt
written personnel policies and procedures which cover:

(a) The manner in which grievances by employees
will be addressed.

(b) The lines of authority.

(c) The required orientation and ongoing training
of employees.

(d) The manner and schedule for evaluating the
performance of the individual employees.

(e) Rules of conduct for employees.

2. The provider shall create and maintain a
written job description for each position, which includes a specific statement
of duties and responsibilities and the minimum level of education, training and
work experience required.

1. The provider shall establish and maintain
a personnel file for each employee. Each individual file must include, without
limitation:

(a) The information required by paragraph (c) of
subsection 2 of NAC 432A.304.

(b) The person’s application for employment,
including a record of his or her previous employment and related references.

(c) Evidence of his or her applicable credentials
and certifications.

(d) An initial medical evaluation, including the
results of a tuberculin test.

(e) A current record of all related training
successfully completed and certification obtained by the employee, including
training in such areas as the administration of first aid and the certification
in the administration of cardiopulmonary resuscitation required pursuant to NAC 432A.322.

(f) A copy of each evaluation of his or her work
performance.

(g) A copy of his or her registration as an alien,
if applicable.

(h) A copy of the rules of conduct for employees
which has been signed by the employee indicating that he or she has received
and understands the rules.

2. The field administrator shall allow each
employee reasonable access to his or her respective personnel file and shall
allow the employee to insert written statements in the file. The provider shall
retain the personnel file of an employee for at least 1 year after the
termination of his or her employment.

(Added to NAC by Bd. for Child Care, eff. 3-11-92; A by
R203-03, 7-1-2004; R112-06, 4-23-2009)

1. The field administrator of a program
which uses volunteers or student interns shall adopt a written plan for using
such assistance. The plan must address such issues as:

(a) The necessary direct supervision of the
volunteer or intern by a paid member of the staff.

(b) The manner and extent of required orientation
and training of the volunteer or intern regarding the philosophy of the
program, the needs of the clients and the methods of meeting those needs.

2. The field administrator shall maintain a
personnel file on each volunteer or intern. The file must include all of the
information required for employees pursuant to NAC
432A.685, except that the record of all related training successfully
completed and certification obtained is only required if that training or
certification is required pursuant to NAC 432A.320.

(Added to NAC by Bd. for Child Care, eff. 3-11-92; A by
R203-03, 7-1-2004)

NAC 432A.695Policy of requirements for eligibility into program. (NRS 432A.077)A
provider shall prepare a written policy of the requirements for eligibility
into his or her program, which must include:

1. Legal status of clients who are eligible
for the program;

2. Age and gender of clients who are
eligible for the program;

3. The needs and problems of clients that
can best be served by the program;

4. The limitations of the program; and

5. A statement that the provider will place
each client in a component of the program which meets the client’s needs in the
manner that is the least restrictive.

(Added to NAC by Bd. for Child Care, eff. 3-11-92)

NAC 432A.700Policy and procedure for admission into program; notice of
admission or refusal to admit client. (NRS
432A.077)

1. A provider shall have a written policy
and procedure for admission into his or her program, which must include:

(a) An explanation of the requirements which must
be met before a client is placed in the program;

1. In emergency situations which necessitate
the immediate placement of a client in a program, an evaluation conducted
pursuant to NRS 432A.450 must
be completed within 30 days.

2. When evaluating a client, the members of
the staff shall consider the client’s age, cultural background and dominant
language or mode of communication.

(Added to NAC by Bd. for Child Care, eff. 3-11-92)

NAC 432A.725Assignment and duties of psychologist or clinical social worker;
contents of plan of treatment. (NRS
432A.077, 432A.450)

1. The field administrator shall assign to
each client a psychologist or clinical social worker who is licensed to
practice in this State. The psychologist or clinical social worker shall
develop, use and review a plan of treatment, which must include:

1. A provider shall prepare a written policy
and procedure for the management of behavior, which must include:

(a) A description of the behavior of a client that
is appropriate and inappropriate; and

(b) Acceptable responses by the members of the
staff to behavior by the client that is inappropriate.

2. The policy and procedure prepared
pursuant to subsection 1 must be provided to each member of the staff. The
staff must receive annual training relating to the management of behavior,
which has been approved by the Division.

3. A member of the staff shall not use or
permit the use of physical restraint or methods that are humiliating or
frightening to control the actions of a client.

4. A member of the staff may use passive
restraint only as a temporary means of physical containment to protect the
client, another person or property. Passive restraint may not be used as a form
of punishment.

5. A member of the staff may not use a method
to incapacitate the client physically, unless the method has been identified
and approved by the Division.

1. A provider shall prepare a written policy
for the rights of its clients, which must include:

(a) A statement concerning the confidentiality of
the information obtained by the provider and of the records that are current
and closed;

(b) The reasons for terminating the participation
of a client involuntarily and the criteria for admitting a client into the
program after he or she has been discharged;

(c) A description of the potential harm to or acts
of violence by a client or another;

(d) A list of the responsibilities of a client,
including the performance of manual tasks and compliance with the rules of
conduct established by the program;

(e) The fee for the services and other costs associated
with the program;

(f) The procedure for filing a grievance or
complaint;

(g) The client’s right to be free from
discrimination;

(h) The client’s right to be treated with dignity;

(i) Except as otherwise provided in NRS 432A.540, the client’s right
to communicate with his or her family, attorney, physician, member of the
clergy or other persons, unless it is determined that communication with a
particular person will not benefit the client;

(j) A list of the persons, if any, whose rights to
visit the client have been restricted by a court;

(k) Except as otherwise provided in NRS 432A.540, the client’s right
to send and receive mail in accordance with applicable requirements regarding
security, health and safety;

(l) The client’s right to use the telephone at the
expense of the client; and

(m) A statement of the rights of clients who smoke,
if any, and of clients who do not smoke.

2. The field administrator shall, upon
admission, present and inform the client of the policy described in subsection
1 orally and in writing in a language or manner that the client understands.

3. The field administrator shall, upon
admission, provide the parent or guardian of the client with a copy of the
policy described in subsection 1.

(Added to NAC by Bd. for Child Care, eff. 3-11-92)

NAC 432A.745Policy regarding transportation of client from his or her home to
location of base camp. (NRS 432A.077, 432A.420)The
field administrator of an outdoor youth program which includes as a part of its
service the escort of a client or prospective client from his or her respective
home or other location to the program’s base camp shall establish a written
policy regarding the manner of transportation and treatment of the client
during the escort. The primary purpose of the policy must be to ensure the
safety of the client. The policy must prohibit the transportation of a client
or prospective client without his or her consent. The policy must require the
use of techniques for transportation and treatment which are the least
restrictive techniques that are possible under the circumstances.

(Added to NAC by Bd. for Child Care, eff. 3-11-92)

NAC 432A.750Contents of written procedures regarding transportation of
clients. (NRS 432A.077, 432A.420)The
written procedures regarding the transportation of clients which are adopted by
the field administrator pursuant to NRS
432A.420 must require:

1. That the equipment in each vehicle for
the administration of first aid must comply with the recommendations of the
American Red Cross.

2. The staff and clients to comply with all
applicable safety laws and regulations, including the mandatory use of safety
belts and shoulder harnesses.

(Added to NAC by Bd. for Child Care, eff. 3-11-92)

NAC 432A.755Contact between field staff and base camp. (NRS 432A.077, 432A.490)In
addition to the requirements of NRS
432A.490, the field staff must be able to communicate with the base camp by
radio at all times. The field administrator shall provide for a system of
physical contact in the event that the system for communication by radio fails.

(Added to NAC by Bd. for Child Care, eff. 3-11-92)

NAC 432A.760Compliance with requirements and policies regarding sanitation
and use of land; instruction regarding reduction of impact on land. (NRS 432A.077, 432A.500)

1. A field administrator shall ensure that
the clients and staff of the outdoor youth program comply with all applicable
laws, regulations and policies regarding sanitation, the use of the land and
the desire to reduce the impact their presence has on the land.

2. The field administrator shall direct the
staff of the program to provide daily instruction to the clients of the program
regarding the reduction of their impact on the land while they are camping or
engaging in other activities on undeveloped land.

(Added to NAC by Bd. for Child Care, eff. 3-11-92)

NAC 432A.765Contents of plan for preventing diseases and coping with
emergencies; approval of plan regarding infectious and communicable diseases. (NRS 432A.077, 432A.430)In the
written general plan for preventing diseases and coping with emergencies
prepared pursuant to NRS 432A.430,
the field administrator shall include procedures to be followed in the base
camp as well as in the field. The plan for the prevention and elimination of
infectious and communicable diseases must be approved by the local health
authority.

1. A provider must prepare a written policy
for documenting and reporting to the Division all deaths of clients, injuries,
fights, physical confrontations, uses of passive physical restraints, suspected
incidents of abuse or neglect and other situations or circumstances affecting
the health or safety of a client. The documentation must include:

(a) A summary of the incident;

(b) The date and time of emergency intervention, if
any;

(c) A list of any referrals made;

(d) Information obtained after the incident; and

(e) The signature of the person preparing the
report.

2. The provider shall maintain a copy of the
report in the respective file of each client involved in an incident described in
subsection 1.

3. If an incident involves the abuse,
neglect or death of a client, the provider shall:

(a) Prepare a preliminary written report within 24
hours after the incident; and

(b) Notify the Division, the parent or guardian of
the client and the appropriate law enforcement agency.

(Added to NAC by Bd. for Child Care, eff. 3-11-92)

NAC 432A.775Report of grievance by client. (NRS
432A.077)A
provider shall prepare a written report for each grievance made by a client,
which must include:

1. The nature of the grievance; and

2. The conclusion or disposition of the
grievance.

(Added to NAC by Bd. for Child Care, eff. 3-11-92)

NAC 432A.780Revocation of license for violation of statute or regulation. (NRS 432A.077, 432A.190)The
Administrator of the Division shall immediately revoke any license issued to an
outdoor youth program pursuant to the provisions of chapter 432A of NRS if the
Administrator reasonably believes that any applicable statute or regulation has
been violated.